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https://www.readbyqxmd.com/read/28595298/lowered-rilpivirine-exposure-during-third-trimester-of-pregnancy-in-hiv-1-positive-women
#1
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 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 (QD) in HIV-1-positive women during late pregnancy. Methods: We conducted a non-randomized, open-label, multi-centre, phase-IV study. HIV-positive pregnant women receiving rilpivirine 25 mg QD were included...
June 8, 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
#2
Tim R Cressey, Baralee Punyawudho, Sophie Le Coeur, Gonzague Jourdain, Chalermpong Saenjum, Edmund 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 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)...
May 9, 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
#3
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
https://www.readbyqxmd.com/read/28458735/features-of-maternal-hiv-1-associated-with-lack-of-vertical-transmission
#4
REVIEW
Nafees Ahmad, Aamir N Ahmad, Shahid N Ahmad
HIV-1 is transmitted from mother-to-child (vertical transmission) at an estimated rate of approximately 30% without any antiretroviral therapy (ART). However, administration of ART during pregnancy considerably diminishes the rate of mother-to-child transmission of HIV-1, which has become a standard of perinatal care in HIV-infected pregnant females in developed countries. Moreover, a majority of children born to HIV-infected mothers are uninfected without any ART. In addition, characteristics of HIV-1 and/or cellular factors in the mothers may play a role in influencing or preventing vertical transmission...
2017: Open Virology Journal
https://www.readbyqxmd.com/read/28398096/advances-in-therapy-for-the-prevention-of-hiv-transmission-from-mother-to-child
#5
Marcela A Moretton, Facundo Bertera, Eduardo Lagomarsino, Jennifer Riedel, Diego A Chiappetta, Christian Höcht
Actually, ~17.8 million women and 1.8 million children (<15 years) are currently infected with the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). Particularly, the majority of pediatric infections (>90%) resulted from 'HIV mother-to-child transmission' (MTCT), both in pregnancy, labour, delivery and later by breastfeeding. Due to its high pediatric incidence, MTCT represents a public health concern. Areas covered: In this review, we focus on available treatments and antiretroviral drugs recommended by the World Health Organization, and the main clinical investigations in antiretroviral pharmacotherapy to prevent the MTCT...
May 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28361508/delivering-safer-conception-services-to-hiv-serodiscordant-couples-in-kenya-perspectives-from-healthcare-providers-and-hiv-serodiscordant-couples
#6
Kenneth Ngure, Grace Kimemia, Kristin Dew, Njambi Njuguna, Nelly Mugo, Connie Celum, Jared M Baeten, Renee Heffron
INTRODUCTION: For HIV serodiscordant couples in resource-limited settings, pregnancy is common despite the risk of sexual and/or perinatal HIV transmission. Some safer conception strategies to reduce HIV transmission during pregnancy attempts are available but often not used for reasons including knowledge, accessibility, preference and others. We sought to understand Kenyan health providers' and HIV serodiscordant couples' perspectives and experiences with safer conception. METHODS: Between August 2015 and March 2016, we conducted key informant interviews (KIIs) with health providers from public and private HIV care and fertility clinics and in-depth interviews (IDIs) and focus group discussions (FGDs) with HIV serodiscordant couples participating in an open-label study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) for HIV prevention (the Partners Demonstration Project)...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361500/the-role-of-family-planning-in-achieving-safe-pregnancy-for-serodiscordant-couples-commentary-from-the-united-states-government-s-interagency-task-force-on-family-planning-and-hiv-service-integration
#7
REVIEW
Jennifer Mason, Amy Medley, Sarah Yeiser, Vienna R Nightingale, Nithya Mani, Tabitha Sripipatana, Andrew Abutu, Beverly Johnston, D Heather Watts
INTRODUCTION: People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28319246/estimated-perinatal-hiv-infection-among-infants-born-in-the-united-states-2002-2013
#8
Allan W Taylor, Steven R Nesheim, Xinjian Zhang, Ruiguang Song, Lauren F FitzHarris, Margaret A Lampe, Paul J Weidle, Patricia Sweeney
Importance: Perinatal transmission of human immunodeficiency virus (HIV) can be reduced through services including antiretroviral treatment and prophylaxis. Data on the national incidence of perinatal HIV transmission and missed prevention opportunities are needed to monitor progress toward elimination of mother-to-child HIV transmission. Objective: To estimate the number of perinatal HIV cases among infants born in the United States. Design, Setting, and Participants: Data were obtained from the National HIV Surveillance System on infants with HIV born in the United States (including the District of Columbia) and their mothers between 2002 and 2013 (reported through December 31, 2015)...
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28277349/missed-opportunities-for-prevention-of-mother-to-child-transmission-of-human-immunodeficiency-virus
#9
Gwendolyn B Scott, Susan B Brogly, Daniel Muenz, Alice M Stek, Jennifer S Read
OBJECTIVE: To identify missed opportunities for prevention of mother-to-child transmission of human immunodeficiency virus (HIV). METHODS: Data regarding HIV-infected children born between 2002 and 2009 to HIV-infected women enrolled in the U.S. International Maternal Pediatric Adolescent AIDS Clinical Trials prospective cohort study (protocol P1025) were reviewed. The characteristics of the HIV-infected infants and their mothers and the mothers' clinical management are described...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28242151/-viral-failure-in-infants-perinatally-infected-with-hiv-a-double-punishment
#10
N Trocmé, M-F Courcoux, M-D Tabone, F Hervé, E Bui, P Faucher, L Selleret, M-G Lebrette, G Leverger, C Dollfus
BACKGROUND: Considering the remarkable efficacy of the strategies for preventing mother-to-child transmission of HIV infection (PMTCT), failures are rare in high-resource countries and deserve further investigation. Moreover, infants have been found to be at increased risk of viral failure. We analyzed the factors related to the children's environment, including maternal psychological factors that may be associated with viral failure in children diagnosed before the age of 1 year. PATIENTS AND METHODS: Retrospective study of all HIV-infected infants, born in France between July 2003 and July 2013, diagnosed before the age of 1 year, cared for in a single reference center, comparing the group of children in viral success to the group of children presenting at least one episode of viral failure, using data available in their medical, psychological and social files...
February 24, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28212643/vertical-hiv-transmission-in-perinatally-exposed-infants-in-south-rift-region-of-kenya-a-retrospective-cross-sectional-study
#11
Everline Ashiono, Dunstan Achwoka, Jamlick Mutugi, Joel Rakwar, Andrew Wafula, Otto Nzapfurundi Chabikuli
BACKGROUND: Despite proven efficacy of the prevention mother-to-child transmission of HIV strategy, its adoption in Africa has remained slow. In Kenya, its effectiveness remain unknown. The aim of this study was to assess the effectiveness of a prevention of mother-to-child transmission program in Kenya. METHODS: This retrospective cross-sectional study analyzed 2,642 records of HIV-exposed infants who had a deoxyribonucleic acid polymerase chain reaction test done...
February 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28198351/therapeutic-drug-monitoring-guided-raltegravir-dosing-for-prevention-of-vertical-transmission-in-a-premature-neonate-born-to-a-woman-living-with-perinatally-acquired-hiv
#12
Denise Kreutzwiser, Nancy Sheehan, Natalie Dayneka, Benoît Lemire, Alison Wong, Lindy Samson, Jason Brophy
We report a case of therapeutic drug monitoring guided raltegravir use for the prevention of vertical HIV transmission in a premature neonate born to a woman living with perinatally acquired HIV and documented resistance to multiple HIV drugs. Maternal viral load was above 1,000 copies/mL at delivery. This case demonstrates delayed raltegravir elimination in a neonate born at 33 weeks gestational age and a need for less frequent raltegravir dosing than is used in older infants and children.
February 15, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28176167/assessing-the-impact-of-perinatal-hiv-case-management-on-outcomes-along-the-hiv-care-continuum-for-pregnant-and-postpartum-women-living-with-hiv-philadelphia-2005-2013
#13
Emily A Anderson, Florence M Momplaisir, Catherine Corson, Kathleen A Brady
To evaluate the impact of a Perinatal Medical Case Management (PCM) Program for women living with HIV (WLWH). Characteristics of pregnant and postpartum WLWH were compared between those who engaged in PCM and those who did not. Using secondary data collected from routine HIV surveillance, multivariable regression models were used to evaluate the association between PCM and four outcomes adapted from the HIV care continuum. In multivariable models, compared to WLWH not in PCM, participants (n = 448, 52.8%) were almost twice as likely to achieve HIV suppression before delivery (aOR 1...
February 7, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28158882/missed-opportunities-for-preventing-perinatal-transmission-of-human-immunodeficiency-virus-florida-2007-2014
#14
Mary Jo Trepka, Soumyadeep Mukherjee, Consuelo Beck-Sagué, Lorene M Maddox, Kristopher P Fennie, Diana M Sheehan, Maithri Prabhakar, Dan Thompson, Spencer Lieb
OBJECTIVES: Despite declining numbers of perinatally exposed infants, an increase in perinatal human immunodeficiency virus (HIV) infections from 2011 to 2013 prompted this study to identify missed perinatal HIV prevention opportunities. METHODS: Deidentified records of children born from 2007 through 2014, exposed to HIV perinatally, and reported to the Florida Department of Health were obtained. Crude relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with perinatal transmission, nondiagnosis of maternal HIV infection, and nonreceipt of antiretroviral medication were calculated...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28132520/pregnancy-and-linkage-to-care-among-women-diagnosed-with-hiv-infection-in-61-cdc-funded-health-departments-in-the-united-states-2013
#15
Lauren F FitzHarris, Natasha D Hollis, Steven R Nesheim, Julia L Greenspan, Erica K Dunbar
Timely linkage to HIV care (LTC) following an HIV diagnosis is especially important for pregnant women with HIV to prevent perinatal transmission and improve maternal health. However, limited data are available on LTC among U.S. pregnant women. Our analysis aimed to identify HIV diagnoses among childbearing age (CBA) women (15-44 years old) by pregnancy status and to compare LTC of HIV-infected pregnant women to HIV-infected non-pregnant women. We analyzed 2013 CDC-funded HIV testing data from 61 health departments and 151 directly funded community-based organizations among CBA women...
January 29, 2017: AIDS Care
https://www.readbyqxmd.com/read/28114813/reproductive-health-counseling-delivered-to-women-living-with-hiv-in-the-united-states
#16
Runa H Gokhale, Heather Bradley, John Weiser
Advances in antiretroviral therapy (ART) and reproductive technologies have made transmission of HIV to partners and infants almost completely preventable. Comprehensive reproductive health counseling (CRHC) is an important component of care for women living with HIV, but few women report discussing reproductive health with an HIV care provider. We surveyed a probability sample of U.S. HIV care providers during 2013-2014. Of 2023 eligible providers, 1234 responded (64% adjusted provider response rate). We estimated the percentage delivering CRHC to their female patients...
January 23, 2017: AIDS Care
https://www.readbyqxmd.com/read/28005487/perinatal-hiv-exposure-surveillance-and-reporting-in-the-united-states-2014
#17
Kathleen A Brady, Deborah S Storm, Azita Naghdi, Toni Frederick, Jessica Fridge, Mary Jo Hoyt
OBJECTIVE: We sought to describe the current status of perinatal HIV exposure surveillance (PHES) activities and regulations in the United States and to make recommendations to strengthen PHES. METHODS: In 2014, we sent an online survey to health departments in the 50 states, District of Columbia, Puerto Rico, Virgin Islands, and 6 cities and counties (Chicago, Illinois; Houston, Texas; Los Angeles, California; New York, New York; Philadelphia, Pennsylvania; and San Francisco, California)...
January 2017: Public Health Reports
https://www.readbyqxmd.com/read/27984423/evaluation-of-medication-mediated-effects-in-pharmacoepidemiology
#18
Eric J Tchetgen Tchetgen, Kelesitse Phiri
Medical conditions such as epilepsy or infection with human immunodeficiency virus (HIV) are known to be associated with a spectrum of adverse health outcomes if not appropriately managed by efficacious treatment and care. Medications for such conditions can be potent, and their use might sometimes have unintended health consequences. Prominent examples have emerged in HIV perinatal research in which use of antiretroviral treatment during pregnancy to treat maternal HIV infection and prevent transmission of the virus to the fetus have been shown to be associated with adverse birth outcomes...
May 2017: Epidemiology
https://www.readbyqxmd.com/read/27936863/missed-opportunities-for-repeat-hiv-testing-in-pregnancy-implications-for-elimination-of-mother-to-child-transmission-in-the-united-states
#19
Caiyun Liao, William Christopher Golden, Jean R Anderson, Jenell S Coleman
HIV testing is an effective intervention that is used for reducing perinatal HIV transmission. Centers for Disease Control and Prevention recommends a second HIV test during the third trimester of pregnancy for women in settings with an elevated HIV incidence (≥17 cases per 100,000 person-years). We conducted a retrospective cohort study at a single hospital in Baltimore, Maryland, to determine whether a second HIV test was done and to compare HIV retesting with mandated syphilis retesting. Of women who delivered at this hospital, 98...
January 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27864000/timing-of-initiation-of-antiretroviral-therapy-and-adverse-pregnancy-outcomes-a-systematic-review-and-meta-analysis
#20
Olalekan A Uthman, Jean B Nachega, Jean Anderson, Steve Kanters, Edward J Mills, Françoise Renaud, Shaffiq Essajee, Meg C Doherty, Lynne M Mofenson
BACKGROUND: Although lifelong combination antiretroviral therapy (ART) is recommended for all individuals with HIV, few data exist for pregnancy outcomes associated with ART initiation before conception. We assessed adverse pregnancy outcomes associated with ART initiated before conception compared with that of ART started after conception. METHODS: We did a systematic review of studies from low-income, middle-income, and high-income countries by searching the Cochrane Central Register of Controlled Trials, Embase, LILACS, MEDLINE, Toxline, Web of Knowledge, and WHO Global Index Medicus and trials in progress (International Clinical Trials Registry Platform) for randomised trials, quasi-randomised trials, and prospective cohort studies done between Jan 1, 1980, and June 1, 2016, in which timing of ART initiation in pregnant women living with HIV was reported...
January 2017: Lancet HIV
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