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Perinatal prevent HIV transmission

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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 pediatric clinic, and evaluate the main factors possibly associated with HIV transmission. METHODS: Data on antenatal care, perinatal and neonatal assistance to HIV-infected and HIV-exposed but uninfected children assisted in the clinic from 1996-2013 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...
July 14, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28595298/lowered-rilpivirine-exposure-during-third-trimester-of-pregnancy-in-hiv-1-positive-women
#9
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
#10
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
#11
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
#12
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
#13
REVIEW
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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