目的了解亲生母亲艾滋病检测阴性的患儿S某感染艾滋病的途径。方法对S某父母亲进行详细的流行病学调查,并采集血液进行艾滋病的检测,对S某出生医院接生医护人员现场调查并查看病历,并对S某可能感染来源的Z某及其子的艾滋病感染情况进行核查。结果 S某艾滋病确诊阳性,其父母亲筛查阴性排除感染;S某在出生后使用负压吸引器吸取羊水和分泌物时,可能造成口腔及咽部的粘膜破损,出生后又呕吐羊水数次,呕吐物中的胃酸可能烧灼口腔、咽部和食道,加重破损的程度,而在出生后20 h左右就给其喂养了Z某的母乳3~5 min;Z某是S某母亲的一名感染了艾滋病的毒友,于2011年10月确诊感染艾滋病,Z某在S某出生时并不知道自己感染了艾滋病;Z某儿子也因母婴传播感染艾滋病且比S某早出生3个月,因此判断Z某在给S某哺乳时已经感染艾滋病,并且当时可能已经发病,其母乳的HIV病毒载量可能较高。结论 S某感染艾滋病的最可能途径是经Z某单次母乳喂养导致的艾滋病母婴传播。 Objective To understand the pathogeny of HIV infection in children with negative HIV test of biological mother. Methods To carry out a detailed epidemiological investigation of a certain parent and child of S and to collect blood for AIDS detection. On the scene of a hospital-based health care worker who was born in S, a medical investigation was conducted and medical records were examined. HIV infection verification. S positive result of a diagnosis of AIDS, the negative screening of their parents to rule out infection; S a vacuum suction device after birth to absorb amniotic fluid and secretions, may cause oral and pharyngeal mucosal damage, and vomiting after birth amniotic fluid several times , Stomach acid in vomit may burn the mouth, pharynx and esophagus, aggravate the extent of damage, and gave birth to a certain mother’s milk about 3-5 hours after birth; Z is a mother of a HIV-infected drug addicts were diagnosed with AIDS in October 2011. Z was not aware that he was infected with AIDS at birth. Z. A son was also infected with HIV through mother-to-child transmission and was born 3 months earlier than S , It is concluded that Z was already infected with HIV when she was breastfeeding to S and that she may have been at that time with a higher HIV viral load in her breast milk. Conclusion The most likely way to get HIV infection is through mother-to-child transmission of HIV through a single breastfeeding campaign.