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https://www.readbyqxmd.com/read/29315112/what-is-new-in-perinatal-hiv-prevention
#1
Mary G Fowler, Patricia Flynn, Jim Aizire
PURPOSE OF REVIEW: The purpose of this review is to describe recent clinical trial, laboratory and observational findings that highlight both the progress that can be achieved in elimination of new pediatric infections in international clinical trial settings among HIV-infected breastfeeding women while also describing recent safety concerns related to currently used antiretroviral regimens. The article will also address the ongoing adherence challenges for HIV-infected mothers in taking their antiretroviral drugs...
February 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29283274/using-an-innovative-telehealth-model-to-support-community-providers-who-deliver-perinatal-hiv-care
#2
Tara E Ness, Mary F Annese, Natalia Martinez-Paz, Kenton T Unruh, John D Scott, Brian R Wood
Mountain West AETC (AIDS Education and Training Center) ECHO (Extension for Community Healthcare Outcomes), a longitudinal HIV telemen-toring program, connects community providers and a multidisciplinary specialist team at the University of Washington. The program employs focused lectures and real-time case discussions to educate and support providers in low-resource and rural settings. We assessed the impact of the program on management of perinatal HIV through surveying community providers who participate, and reviewing cases presented by providers for consultation...
December 2017: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
https://www.readbyqxmd.com/read/29236362/implementation-of-repeat-hiv-testing-during-pregnancy-in-southwestern-kenya-progress-and-missed-opportunities
#3
Anna J Rogers, Eliud Akama, Elly Weke, Justin Blackburn, George Owino, Elizabeth A Bukusi, Patrick Oyaro, Zachary A Kwena, Craig R Cohen, Janet M Turan
INTRODUCTION: Repeat HIV testing during the late antenatal period is crucial to identify and initiate treatment for pregnant women with incident HIV infection to prevent perinatal HIV transmission and keep mothers alive. In 2012, the Kenya Ministry of Health adopted international guidelines suggesting that pregnant women be offered retesting three months after an initial negative HIV test. Our objectives were to determine the current rate of antenatal repeat HIV testing; identify successes, missed opportunities and factors associated with retesting; and estimate the incidence of HIV during pregnancy...
December 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29227466/morbidity-and-mortality-of-a-cohort-of-peruvian-hiv-infected-children-2003-2012
#4
Amira N Baker, Angela M Bayer, Rolando M Viani, Lenka Kolevic, Myung-Shin Sim, Jaime G Deville
BACKGROUND: Data on pediatric HIV in Peru is limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under age 18 in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003-2012...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29216874/factors-influencing-the-experience-of-sexual-and-reproductive-healthcare-for-female-adolescents-with-perinatally-acquired-hiv-a-qualitative-case-study
#5
Gertrude Mwalabu, Catrin Evans, Sarah Redsell
BACKGROUND: Young people living with perinatally-acquired HIV require age-appropriate support regarding sex and relationships as they progress towards adulthood. HIV affects both genders but evidence suggests that young women are particularly vulnerable to sexual abuse and more prone to engaging in sexual behaviours to meet their daily survival needs. This can result in poor sexual and reproductive health (SRH) outcomes. HIV services in Malawi provide support for young women's HIV-related clinical needs, but it is unclear whether there is sufficient provision for their SRH needs as they become adults...
December 8, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29208244/role-of-nucleoside-transporters-in-transplacental-pharmacokinetics-of-nucleoside-reverse-transcriptase-inhibitors-zidovudine-and-emtricitabine
#6
S Karbanova, L Cerveny, M Ceckova, Z Ptackova, L Jiraskova, S Greenwood, F Staud
INTRODUCTION: Zidovudine (AZT) and emtricitabine (FTC) are effective and well tolerated antiretroviral drugs, routinely used in the prevention of perinatal HIV transmission. However, precise mechanism(s) involved in their transfer from mother to fetus are not fully elucidated. Since both drugs are nucleoside analogues, we hypothesized that the mechanisms of their transplacental passage might include equilibrative nucleoside transporters, ENT1 and/or ENT2. METHODS: To address this issue, we performed in vitro accumulation assays in the BeWo placental trophoblast cell line, ex vivo uptake studies in fresh villous fragments isolated from human placenta and in situ dually perfused rat term placenta experiments...
December 2017: Placenta
https://www.readbyqxmd.com/read/29040165/dating-violence-against-hiv-infected-youth-in-south-africa-associations-with-sexual-risk-behavior-medication-adherence-and-mental-health
#7
Rachel Kidman, Avy Violari
BACKGROUND: As perinatal HIV-infected youth become sexually active, the potential for onward transmission becomes an increasing concern. In other populations, intimate partner violence (IPV) is a risk factor for HIV acquisition. We build on this critical work by studying the role of IPV in facilitating onward transmission among HIV-infected youth - an important step towards effective intervention. SETTING: Soweto, South Africa. METHODS: Self-report surveys were completed by 129 perinatal HIV-infected female youth (aged 13-24)...
October 14, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29039686/prevention-and-treatment-of-hiv-infection-in-neonates-evidence-base-for-existing-who-dosing-recommendations-and-implementation-considerations
#8
Diana F Clarke, Martina Penazzato, Edmund Capparelli, Tim R Cressey, George Siberry, Nandita Sugandhi, Mark Mirochnick
Antiretroviral drugs are used in neonates for prevention and treatment of HIV infection. Use of antiretrovirals to prevent perinatal HIV transmission is well established. Early identification of neonates infected with HIV and rapid initiation of combination antiretroviral treatment during the neonatal period is now recommended by WHO and DHHS. However, few antiretrovirals are available in formulations suitable for neonates and there are limited safety and pharmacokinetic data for most antiretrovirals in neonates...
October 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29036208/transitioning-couple-s-voluntary-hiv-counseling-and-testing-cvct-from-stand-alone-weekend-services-into-routine-antenatal-and-vct-services-in-government-clinics-in-zambia-s-two-largest-cities
#9
Mubiana Inambao, William Kilembe, Lauren A Canary, Nancy L Czaicki, Matilda Kakungu-Simpungwe, Roy Chavuma, Kristin M Wall, Amanda Tichacek, Julie Pulerwitz, Ibou Thior, Elwyn Chomba, Susan A Allen
INTRODUCTION: Most HIV infections in Africa are acquired by married/cohabiting adults and WHO recommends couple's voluntary HIV counseling and testing (CVCT) for prevention. The handover from NGO-sponsored weekend CVCT to government-sponsored services in routine weekday antenatal care (ANC) and individual voluntary testing and counseling (VCT) services in Zambia's two largest cities from 2009-2015 is described. METHODS: Government clinic counselors were trained to provide CVCT, and along with community health workers they promoted CVCT services in their clinic and surrounding areas...
2017: PloS One
https://www.readbyqxmd.com/read/28899162/high-levels-of-viral-suppression-among-east-african-hiv-infected-women-and-men-in-serodiscordant-partnerships-initiating-antiretroviral-therapy-with-high-cd4-counts-and-during-pregnancy
#10
Andrew Mujugira, Jared Baeten, Lara Kidoguchi, Jessica Haberer, Connie Celum, Deborah Donnell, Kenneth Ngure, Elizabeth Bukusi, Nelly Mugo, Stephen Asiimwe, Josephine Odoyo, Edna Tindimwebwa, Nulu Bulya, Elly Katabira, Renee Heffron
BACKGROUND: People who are asymptomatic and feel healthy, including pregnant women, may be less motivated to initiate ART or achieve high adherence. We assessed whether ART initiation, and viral suppression 6, 12 and 24-months after ART initiation, were lower in HIV-infected members of serodiscordant couples who initiated during pregnancy or with higher CD4 counts. METHODS: We used data from the Partners Demonstration Project, an open-label study of the delivery of integrated PrEP and ART (at any CD4 count) for HIV prevention among high-risk HIV serodiscordant couples in Kenya and Uganda...
September 13, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28891343/current-and-future-contraceptive-options-for-women-living-with-hiv
#11
Rena C Patel, Elizabeth A Bukusi, Jared M Baeten
Among women living with HIV, half of the pregnancies are unintended. Effective contraception can prevent unintended pregnancies and consequently reduce maternal mortality and perinatal transmission of HIV. While contraceptive options available for all women also apply to women living with HIV, specific considerations exist to the use of contraception by women living with HIV. Areas covered: First, general principles guiding the use of contraception among women living with HIV are discussed, such as choice, method mix, relative effectiveness, and drug-drug interactions...
September 11, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28841701/pregnancy-outcomes-in-perinatally-hiv-infected-young-women-in-madrid-spain-2000-2015
#12
Luis M Prieto, Carolina Fernández McPhee, Patricia Rojas, Diana Mazariegos, Eloy Muñoz, Maria José Mellado, África Holguín, María Luisa Navarro, María Isabel González-Tomé, José Tomás Ramos
BACKGROUND: An increasing number of perinatally HIV-infected women (PHIV) are reaching adulthood and becoming pregnant. Most PHIV women have been exposed to a high number of antiretroviral regimens, and they may have difficulties to achieve viral suppression. Psychosocial problems are not uncommon and could be an important barrier for treatment adherence. The effects of chronic HIV infection and long-term exposure to antiretroviral treatment of PHIV women cause concerns on the developing fetus...
2017: PloS One
https://www.readbyqxmd.com/read/28799825/progress-toward-elimination-of-perinatal-hiv-transmission-in-kenya-analysis-of-early-infant-diagnosis-data
#13
Dunstan Achwoka, Justin Mandala, Mutugi Muriithi, Yanwu Zeng, Mario Chen, Rebecca Dirks, Martin Sirengo, Rose Wafula, Kwasi Torpey
Interrupting vertical transmission of HIV from mothers to infants provides opportunity to transform the HIV/AIDS epidemic by eliminating new infections among children. We estimate mother-to-child transmission rates of infants born to known HIV-positive mothers offered prevention of mother-to-child transmission interventions and provide an indication of Kenya's progress toward elimination of perinatal transmission. We obtained from the Kenya National Early Infant Diagnosis (EID) database, all 131,451 DNA polymerase chain reaction test results of HIV-exposed infants aged 0-18 months who had dried blood spot samples taken between January 2008 and October 2013...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28747410/a-systematic-review-and-meta-analysis-of-studies-evaluating-the-performance-and-operational-characteristics-of-dual-point-of-care-tests-for-hiv-and-syphilis
#14
REVIEW
Harriet D Gliddon, Rosanna W Peeling, Mary L Kamb, Igor Toskin, Teodora E Wi, Melanie M Taylor
BACKGROUND: Mother-to-child transmission (MTCT) of syphilis and HIV continue to be important yet preventable causes of perinatal and infant morbidity and mortality. OBJECTIVES: To systematically review, critically appraise and perform a meta-analysis to evaluate the operational characteristics of dual rapid diagnostic tests (RDTs) for HIV/syphilis and evaluate whether they are cost effective, acceptable and easy to use. DESIGN: Systematic review and meta-analysis...
July 26, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28729100/an-evaluation-of-introduction-of-rapid-hiv-testing-in-a-perinatal-program
#15
Sarah Saunders, Karen Tulloch, Evelyn J Maan, Julianne van Schalkwyk, Deborah M Money
OBJECTIVE: This study was conducted to evaluate the roll-out of rapid HIV testing as part of an emergency Prevention of Perinatal HIV Transmission Program. Specifically, HIV prevalence in this population, the reason(s) for performing the rapid HIV test, and compliance with recommendations for antiretroviral prophylaxis were assessed. METHODS: Since November 2011, all women presenting to a tertiary labour and delivery unit with unknown HIV status or with ongoing risk of HIV infection since their last HIV test were offered rapid HIV testing...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28714809/reticence-in-disclosure-of-hiv-infection-and-reasons-for-bereavement-impact-on-perinatally-infected-adolescents-mental-health-and-understanding-of-hiv-treatment-and-prevention-in-johannesburg-south-africa
#16
Nataly Woollett, Vivian Black, Lucie Cluver, Heena Brahmbhatt
Survival rates of perinatally infected HIV-positive adolescents (PIA) are increasing in sub-Saharan Africa. There is a gap in understanding how disclosure and bereavement have an impact on PIA beliefs and understanding of their HIV infection and its management. In-depth interviews were conducted with 25 purposively selected adolescents aged 13-19 years from 5 public health clinics in Johannesburg, South Africa. Data were analysed using NVivo 10 using a thematic approach. PIA experience incomplete disclosure both of their HIV status and reasons for their bereavements, which limits their understanding of how they became infected, vertical transmission and prevention options like prevention of mother-to-child transmission (PMTCT)...
July 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28707345/the-cascade-of-care-to-prevent-mother-to-child-transmission-in-rio-de-janeiro-brazil-1996-2013-improving-but-still-some-way-to-go
#17
Cristina Barroso Hofer, Matthias Egger, Mary-Ann Davies, Ana Cristina Cisne Frota, Ricardo Hugo de Oliveira, Thalita Fernandes Abreu, Lúcia Evangelista Araújo, Bernardo Bastos Witthlin, Alice Weber Carvalho, Janaína Rivas Cordeiro, Giulia Pasqualini Lima, Olivia Keiser
OBJECTIVE: To describe the cascade of care to HIV mother-to-child transmission (PMTCT) in a Rio de Janeiro reference paediatric clinic and evaluate the main factors possibly associated with HIV transmission. METHODS: Data on antenatal care (ANC), perinatal and neonatal assistance to HIV-infected and HIV-exposed but uninfected children assisted in the clinic from 1996 to 2013 were collected. The cascade of care was graphically demonstrated, and possible factors associated with HIV infection were described using regression models for bivariate and multivariate analysis...
October 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28595298/lowered-rilpivirine-exposure-during-the-third-trimester-of-pregnancy-in-human-immunodeficiency-virus-type-1-infected-women
#18
Stein Schalkwijk, Angela Colbers, Deborah Konopnicki, Andrea Gingelmaier, John Lambert, Marchina van der Ende, José Moltó, David Burger
Background: The use of antiretroviral therapy during pregnancy is important for control of maternal human immunodeficiency virus (HIV) disease and the prevention of perinatal HIV transmission. Physiological changes during pregnancy can reduce antiretroviral exposure. We studied the pharmacokinetics of rilpivirine 25 mg once daily in HIV-1-infected women during late pregnancy. Methods: We conducted a nonrandomized, open-label, multicenter, phase 4 study. HIV-infected pregnant women receiving rilpivirine 25 mg once daily were included...
October 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28489732/assessment-of-nevirapine-prophylactic-and-therapeutic-dosing-regimens-for-neonates
#19
MULTICENTER STUDY
Tim R Cressey, Baralee Punyawudho, Sophie Le Coeur, Gonzague Jourdain, Chalermpong Saenjum, Edmund V Capparelli, Kanokwan Jittayanun, Siriluk Phanomcheong, Anita Luvira, Thitiporn Borkird, Achara Puangsombat, Leon Aarons, Pra-Ornsuda Sukrakanchana, Saik Urien, Marc Lallemant
BACKGROUND: Nevirapine (NVP) is a key component of antiretroviral prophylaxis and treatment for neonates. We evaluated current World Health Organization (WHO) weight-band NVP prophylactic dosing recommendations and investigated optimal therapeutic NVP dosing for neonates. METHODS: The PHPT-5 study in Thailand assessed the efficacy of "Perinatal Antiretroviral Intensification" to prevent mother-to-child transmission of HIV in women with <8 weeks of antiretroviral treatment before delivery (NCT01511237)...
August 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28482821/understanding-coping-strategies-during-pregnancy-and-the-postpartum-period-a-qualitative-study-of-women-living-with-hiv-in-rural-uganda
#20
Scholastic Ashaba, Angela Kaida, Bridget Frances Burns, Kasey O'Neil, Emma Dunkley, Christina Psaros, Jasmine Kastner, Alexander C Tsai, David R Bangsberg, Lynn T Matthews
BACKGROUND: In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women...
May 8, 2017: BMC Pregnancy and Childbirth
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