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HIV pregnancy

Ruben van der Galiën, Rob Ter Heine, Rick Greupink, Stein J Schalkwijk, Antonius E van Herwaarden, Angela Colbers, David M Burger
Prevention of mother-to-child transmission of HIV and optimal maternal treatment are the most important goals of antiretroviral therapy in pregnant women with HIV. These goals may be at risk due to possible reduced exposure during pregnancy caused by physiological changes. Limited information is available on the impact of these physiological changes. This is especially true for HIV-integrase inhibitors, a relatively new class of drugs, recommended first-line agents and hence used by a large proportion of HIV-infected patients...
June 19, 2018: Clinical Pharmacokinetics
Anne M Rompalo, Neko Castleberry, Lea Widdice, Jay Schulkin, Charlotte A Gaydos
Background: Point-of-care tests (POCTs) for reproductive health conditions have existed for decades. Newer POCTs for syphilis, HIV and trichomonas are currently available and easy to use. We surveyed practicing obstetricians and gynaecologists to determine current POCT use and perceived obstacles to use. Methods: Between June and August 2016, 1000 members of the American College of Obstetricians and Gynecologists were randomly selected and invited to complete a Qualtrics (222 West river Park Drive, Provo, Utah 84604, USA) survey; 600 of these were members of the Collaborative Ambulatory Research Network...
June 19, 2018: Sexual Health
J Odayar, M X Rangaka, A Zerbe, G Petro, J A McIntyre, T K Phillips, E J Abrams, L Myer
BACKGROUND: The burden of active tuberculosis (TB) in pregnancy compared with preconception and postpartum is unclear, particularly with universal antiretroviral therapy (ART) initiation in pregnancy. METHODS: We retrospectively compared active TB incidence in the 18 months preconception, during pregnancy and up to 6 months postpartum in human immunodeficiency virus (HIV) positive women attending antenatal care at a primary health care facility in Cape Town from 2013 to 2014...
July 1, 2018: International Journal of Tuberculosis and Lung Disease
Kefyalew Addis Alene, Kendalem Asmare Atalell
BACKGROUND: Providing preferred methods of contraceptive for HIV-positive women and avoiding unintended pregnancy is one of the primary means of preventing mother to child transmission of HIV. This study assessed the prevalence of contraceptive use and method preference among HIV-positive women in Amhara region, Ethiopia. METHODS: A cross-sectional survey was conducted among HIV-positive women in three referral hospitals of Amhara region. Data were collected by interviewing HIV-positive women using a pre-tested and structured questionnaire...
June 18, 2018: BMC Women's Health
Emily H Adhikari, Devin Macias, Donna Gaffney, Sarah White, Vanessa L Rogers, Donald D McIntire, Scott W Roberts
BACKGROUND: False positive HIV screening tests in pregnancy may lead to unnecessary interventions in labor. In 2014, the Centers for Disease Control and Prevention released a new algorithm for HIV diagnosis using a 4th generation screening test, which detects antibodies to HIV as well as p24 antigen and has a shorter window period compared with prior generations. A reactive screen requires a differentiation assay, and supplemental qualitative RNA testing is necessary for nonreactive differentiation assay...
June 15, 2018: American Journal of Obstetrics and Gynecology
Christina Lumbantoruan, Michelle Kermode, Aloisius Giyai, Agnes Ang, Margaret Kelaher
BACKGROUND: Despite a more proactive approach to reducing new HIV infections in infants through lifelong treatment (Option B+ policy) for infected pregnant women, prevention of mother-to-child transmission of HIV (PMTCT) has not been fully effective in Papua, Indonesia. Mother-to-child transmission (MTCT) is the second greatest risk factor for HIV infection in the community, and an elimination target of <1% MTCT has not yet been achieved. The purpose of this study was to improve understanding of the implementation of Option B+ for PMTCT in Papua through investigation of facilitators and barriers to women's uptake and adherence to antiretroviral therapy (ART) in the program...
2018: PloS One
Areti Angeliki Veroniki, Jesmin Antony, Sharon E Straus, Huda M Ashoor, Yaron Finkelstein, Paul A Khan, Marco Ghassemi, Erik Blondal, John D Ivory, Brian Hutton, Kevin Gough, Brenda R Hemmelgarn, Erin Lillie, Afshin Vafaei, Andrea C Tricco
BACKGROUND: Nearly all newly infected children acquire Human Immunodeficiency virus (HIV) via mother-to-child transmission (MTCT) during pregnancy, labour or breastfeeding from untreated HIV-positive mothers. Antiretroviral therapy (ART) is the standard care for pregnant women with HIV. However, evidence of ART effectiveness and harms in infants and children of HIV-positive pregnant women exposed to ART has been largely inconclusive. The aim of our systematic review and network meta-analysis (NMA) was to evaluate the comparative safety and effectiveness of ART drugs in children exposed to maternal HIV and ART (or no ART/placebo) across different study designs...
2018: PloS One
Sylvia M LaCourse, Lisa M Cranmer, Adrie Bekker, Karen R Steingart, Danae Black, David J Horne, Eyal Oren, Sherri Pals, Surbhi Modi, Jyoti Mathad
This is a protocol for a Cochrane Review (Diagnostic test accuracy). The objectives are as follows: To assess the accuracy of the four-symptom screen (cough, fever, night sweats, or weight loss) for identifying active TB in pregnant PLHIV who are screened in an outpatient or community setting. To investigate potential sources of heterogeneity of the accuracy of the four-symptom screen between studies including: ART status, CD4 cell count, gestational age, pregnancy stage (pregnancy vs. postpartum), screening test definition of cough (any cough vs...
2018: Cochrane Database of Systematic Reviews
Jonathan Huang, Brenda Eskenazi, Riana Bornman, Stephen Rauch, Jonathan Chevrier
BACKGROUND: Indoor residual spraying (IRS) of insecticides, conducted in low- and middle-income countries to control malaria, may result in high exposure to dichlorodiphenyltrichloroethane (DDT), its breakdown product dichlorodiphenyldichloroethylene (DDE), or pyrethroids. Animal studies suggest in utero exposure to these chemicals may increase childhood infection frequency. OBJECTIVES: We investigated associations between maternal DDT/E and pyrethroid metabolite concentration and child infection associations in an IRS setting in which susceptibility factors are common and infections are leading causes of child morbidity and mortality...
June 2018: Environmental Health Perspectives
Laura Kann, Tim McManus, William A Harris, Shari L Shanklin, Katherine H Flint, Barbara Queen, Richard Lowry, David Chyen, Lisa Whittle, Jemekia Thornton, Connie Lim, Denise Bradford, Yoshimi Yamakawa, Michelle Leon, Nancy Brener, Kathleen A Ethier
PROBLEM: Health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults in the United States. In addition, significant health disparities exist among demographic subgroups of youth defined by sex, race/ethnicity, and grade in school and between sexual minority and nonsexual minority youth. Population-based data on the most important health-related behaviors at the national, state, and local levels can be used to help monitor the effectiveness of public health interventions designed to protect and promote the health of youth at the national, state, and local levels...
June 15, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
The Lancet
No abstract text is available yet for this article.
June 9, 2018: Lancet
Jamie W Krashin, Lisa B Haddad, Hannock Tweya, Jane Chiwoko, Wingston Ng'ambi, Bernadette Samala, Thomas Chaweza, Jennifer H Tang, Mina C Hosseinipour, Sam Phiri
As access to antiretroviral therapy increases, more HIV-infected patients in sub-Saharan Africa may desire fertility. We conducted a cross-sectional study of reproductive health knowledge, attitudes and practices to identify factors associated with desired fertility among women and men receiving care at two large public HIV clinics in Lilongwe, Malawi. Research assistants administered questionnaires to participants. We performed descriptive, bivariable and multivariable analysis of factors related to desired fertility and of factors related to contraceptive non-use among participants who did not desire fertility...
2018: PloS One
P Naidoo, R N Naidoo, P Ramkaran, S Muttoo, K Asharam, A A Chuturgoon
OBJECTIVE: Nitrogen oxide (NOx) pollution and human immunodeficiency virus (HIV)/AIDS intensify inflammation during pregnancy and linked with adverse birth outcomes (ABOs). MicroRNA (miRNA)-146a plays a crucial role in regulating inflammation in the NF-κB pathway. The G/C rs2910164 dampens miRNA-146a activity and linked with inflammatory diseases. The present study investigated whether HIV/AIDS and NOx exposure throughout pregnancy further intensifies ABO in Black South African women genotyped for the rs2910164...
January 1, 2018: Human & Experimental Toxicology
Maria Pyra, Peter L Anderson, Craig W Hendrix, Renee Heffron, Kenneth Mugwanya, Jessica E Haberer, Katherine K Thomas, Connie Celum, Deborah Donnell, Mark A Marzinke, Elizabeth A Bukusi, Nelly R Mugo, Stephen Asiimwe, Elly Katabira, Jared M Baeten
OBJECTIVES: Pregnancy is a time of increased HIV acquisition risk and pregnancy reduces concentrations of antiretrovirals used for treatment. We assessed whether pregnancy lowers concentrations of tenofovir (TFV) and tenofovir-diphosphate (TFV-DP) among HIV-uninfected women using oral pre-exposure prophylaxis (PrEP). METHODS: We analyzed data from an open-label PrEP study, comparing concentrations of TFV in plasma and TFV-DP in dried blood spots (DBS) among 37 pregnant women and 97 non-pregnant women...
June 11, 2018: AIDS
S B Cele, F Odun-Ayo, O A Onyangunga, J Moodley, T Naicker
OBJECTIVE: Hepatocyte Growth Factor (HGF) plays a role in the migration and morphogenesis of different cell types and tissues. Preeclampsia (PE) is associated with deficient trophoblast invasion and placental insufficiency; hence HGF production is expected to be compromised. This study therefore aimed to immunolocalize and morphometrically analyse placental HGF in normotensive versus PE pregnancies stratified by HIV status and gestational age. STUDY DESIGN: Normotensive (N; n = 40) and preeclamptic (PE; n = 80) women were stratified by HIV status (HIV- and HIV+), and gestational age i...
June 1, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jienchi Dorward, Richard Lessells, Paul K Drain, Kogieleum Naidoo, Tulio de Oliveira, Yogan Pillay, Salim S Abdool Karim, Nigel Garrett
A new first-line antiretroviral therapy (ART) regimen containing dolutegravir is being rolled out in low-income and middle-income countries (LMICs). In studies from predominantly high-income settings, dolutegravir-based regimens had superior efficacy, tolerability, and durability compared with existing first-line regimens. However, several questions remain about the roll out of dolutegravir in LMICs, where most people with HIV are women of reproductive age, tuberculosis prevalence can be high, and access to viral load and HIV drug resistance testing is limited...
June 5, 2018: Lancet HIV
Carolyn M Audet, Erin Graves, Ezequiel Barreto, Caroline De Schacht, Wu Gong, Bryan E Shepherd, Arifo Aboobacar, Lazaro Gonzalez-Calvo, Maria Fernanda Alvim, Muktar H Aliyu, Aaron M Kipp, Heather Jordan, K Rivet Amico, Matthew Diemer, Andrea Ciaranello, Caitlin Dugdale, Sten H Vermund, Sara Van Rompaey
BACKGROUND: In resource-limited rural settings, scale-up of services to eliminate mother-to-child transmission of HIV has not been as effective as in better resourced urban settings. In sub-Saharan Africa, women often require male partner approval to access and remain engaged in HIV care. Our study will evaluate a promising male engagement intervention ("Homens para Saúde Mais" (HoPS+) [Men for Health Plus]) targeting the elimination of mother-to-child transmission in rural Mozambique...
June 5, 2018: Contemporary Clinical Trials
Nigusie Fetene, Wubegzier Mekonnen
BACKGROUND: Risky sexual behaviors adversely affect the health of youth and young adults exposing them to sexually transmitted infections including HIV/AIDS and unwanted pregnancy to females that in turn lead to deleterious health, social and economic consequences. Youth centers inform their clients on sexually transmitted diseases, including HIV/AIDS, unwanted pregnancy, high risk abortion, and other reproductive health problems. Therefore, this study was designed to assess the prevalence of risky sexual behaviors among youth center reproductive health clinic users and non-users in Addis Ababa...
2018: PloS One
Takassi Ounoo Elom, Salou Mounérou, Fiawoo Mawouto, Guédénon Koffi, Akpadja Koffi, Atakouma Yawo
INTRODUCTION: Preventing mother-to-child transmission (PMTCT) of HIV decreases new HIV infections in children. The objectives of our study were to describe the sociodemographic and obstetric characteristics of the patients of a protocol for the PMTCT of HIV-1 in Sylvanus Olympio Teaching Hospital. METHODS: We conducted a prospective cross-sectional descriptive study of the follow-up cohort type in the PMTCT siteof Sylvanus Olympio Teaching Hospital. It extended from 27 June 2011 to 27 May 2015...
December 2017: La Tunisie Médicale
Michael O Mireku, Leslie L Davidson, Romeo Zoumenou, Achille Massougbodji, Michel Cot, Florence Bodeau-Livinec
OBJECTIVE: To investigate the relationship between prenatal geophagy, maternal prenatal haematological indices, malaria, helminth infections and cognitive and motor development among offspring. METHODS: At least a year after delivery, 552 of 863 HIV-negative mothers with singleton births who completed a clinical trial comparing the efficacy of sulfadoxine-pyrimethamine and mefloquine during pregnancy in Allada, Benin, responded to a nutrition questionnaire including their geophageous habits during pregnancy...
June 7, 2018: Tropical Medicine & International Health: TM & IH
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