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Kristen M Little, Allan W Taylor, Craig B Borkowf, Maria C B Mendoza, Margaret A Lampe, Paul J Weidle, Steven R Nesheim
OBJECTIVE: Using published, nationally representative estimates, we calculated the total number of perinatally HIV-exposed and -infected infants born during 1978-2010, the number of perinatal HIV cases prevented by interventions designed for the prevention of mother-to-child transmission (PMTCT), and the number of infants exposed to antiretroviral drugs during the prenatal and intrapartum periods. DESIGN: We calculated the number of infants exposed to antiretroviral drugs since 1994, and the number of cases of mother-to-child HIV transmission prevented from 1994-2010 using published data...
September 30, 2016: Pediatric Infectious Disease Journal
Zhangmin Tan, Yuzhu Yin, Jin Zhou, Lingling Wu, Chengfang Xu, Hongying Hou
This prospective study evaluated the viability of telbivudine for blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) infection.Pregnant women positive for the hepatitis B surface antigen began telbivudine treatment before 14 weeks of gestation (i.e., early), between 14 and 28 weeks of gestation (late), or not at all (control). In the late-treatment group, 55 women terminated telbivudine therapy within puerperium. All neonates underwent routine hepatitis B immunoglobulin plus vaccination...
October 2016: Medicine (Baltimore)
Stephane Helleringer
New HIV infections among children have declined significantly more slowly in West and central African countries (WCA) than in eastern and southern African countries between 2009 and 2015. Since adolescent fertility is particularly high in WCA countries, frequent mother-to-child transmission (MTCT) of HIV may in part be due to low coverage of HIV testing among adolescents during antenatal care (ANC). We investigated this adolescent gap in HIV testing using survey data from the demographic and health surveys and multiple indicators cluster surveys collected in 21 WCA countries since 2009...
October 12, 2016: AIDS and Behavior
Ameena E Goga, Thu-Ha Dinh, Debra J Jackson, Carl J Lombard, Adrian Puren, Gayle Sherman, Vundli Ramokolo, Selamawit Woldesenbet, Tanya Doherty, Nobuntu Noveve, Vuyolwethu Magasana, Yagespari Singh, Trisha Ramraj, Sanjana Bhardwaj, Yogan Pillay
BACKGROUND: Eliminating mother-to-child transmission of HIV (EMTCT), defined as ≤50 infant HIV infections per 100 000 live births, is a global priority. Since 2011 policies to prevent mother-to-child transmission of HIV (PMTCT) shifted from maternal antiretroviral (ARV) treatment or prophylaxis contingent on CD4 cell count to lifelong maternal ARV treatment (cART). We sought to measure progress with early (4-8 weeks postpartum) MTCT prevention and elimination, 2011-2013, at national and sub-national levels in South Africa, a high antenatal HIV prevalence setting ( ≈ 29%), where early MTCT was 3...
December 2016: Journal of Global Health
Pesona Grace Lucksom, Rekha Upadhya, Latha Kharka, Swati Dubey, Nishi Choudhary, Ruby Yadav
BACKGROUND: This study was conducted to determine whether antenatal mothers in Sikkim have adequate knowledge about awareness, attitude, and preventive practices regarding HIV infection. METHODS: Cross-sectional study using structured questionnaire. 220 Antenatal mothers attending the outpatient department of Central Referral Hospital of Sikkim were taken for the study for a period of 1 year from April 2011 to April 2012. Questionnaire form filled by pregnant women during their first antenatal visit was the source of data for this study...
October 2016: Journal of Obstetrics and Gynaecology of India
Alexander Suuk Laar, Veloshnee Govender
OBJECTIVES: International guidelines on infant feeding for HIV- positive mothers promote Exclusive Replacement Feeding (ERF) (infant formula or animal milk) or exclusive breastfeeding (with no supplements of any kind). A mixed feeding pattern, where breastfeeding is combined with other milks, liquid foods or solids, has been shown to increase the risk of transmission of HIV and is strongly discouraged. However, little is known about the ability of women to adhere to recommended feeding strategies to prevent mother-to-child transmission (MTCT) of HIV from breast milk...
2013: Int J MCH AIDS
Antoni Soriano-Arandes, Antoni Noguera-Julian, Mónica López-Lacort, Pere Soler-Palacín, Antonio Mur, María Méndez, Lluís Mayol, Teresa Vallmanya, Jesús Almeda, Dolors Carnicer-Pont, Jordi Casabona, Claudia Fortuny
INTRODUCTION: Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014. METHODS: A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014...
September 5, 2016: Enfermedades Infecciosas y Microbiología Clínica
Cynthia D Fair, Jamie N Albright, Devon M Clark, Bethany Houpt
Introduction: Parents and caregivers of typically developing teens are often a source of information about sexual health and relationships. However, little is known about the information offered to adolescents with perinatally acquired HIV (APHIV) by caregivers who may provide support and guidance to their teen as they explore sexuality and childbearing. Method: This qualitative exploratory study involved the in-depth interviews of 18 caregivers (17 females), including biological mothers (9), relatives (5), and adoptive/foster mothers (4), who care for APHIV...
August 29, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Gonzague Jourdain, Nicole Ngo-Giang-Huong, Tim R Cressey, Lei Hua, Linda Harrison, Camlin Tierney, Nicolas Salvadori, Luc Decker, Patrinee Traisathit, Wasna Sirirungsi, Woottichai Khamduang, Chureeratana Bowonwatanuwong, Thanyawee Puthanakit, George K Siberry, Diane Heather Watts, Trudy V Murphy, Jullapong Achalapong, Suchat Hongsiriwon, Virat Klinbuayaem, Satawat Thongsawat, Raymond T Chung, Stanislas Pol, Nantasak Chotivanich
BACKGROUND: Chronic hepatitis B virus (HBV) infection is complicated by cirrhosis and liver cancer. In Thailand, 6-7 % of adults are chronically infected with HBV. The risk of mother-to-child transmission (MTCT) of HBV has been estimated to be about 12 % when mothers have a high hepatitis B viral load, even if infants receive passive-active prophylaxis with HBV immunoglobulin (HBIg) and initiate the hepatitis B vaccine series at birth. We designed a study to assess the efficacy and safety of a short course of maternal tenofovir disoproxil fumarate (TDF) among women with a marker of high viral load for the prevention of MTCT of HBV...
2016: BMC Infectious Diseases
Paolo Palma
A significant proportion of mother-to-child transmission (MTCT) of HIV still occurs during breastfeeding in settings where replacement feeding is unsafe and impractical. However, very few babies born to HIV-infected women and breastfed during the first 6 months of life become infected postnatally. The fact that the majority of babies who are breastfed by HIV-infected mothers remain uninfected even after several months of breastfeeding constitutes one of the major enigmas of HIV transmission via breast milk.
2016: Journal of Virus Eradication
Karoline Aebi-Popp, Andrea Duppenthaler, Andri Rauch, Andrea De Gottardi, Christian Kahlert
At present, routine antenatal hepatitis C virus (HCV) screening is not recommended in pregnant women who do not have known risk factors for infection. The main reason for this attitude has been the lack of effective treatment options to avoid mother-to-child transmission (MTCT) during pregnancy or delivery. Hitherto available treatment regimens based on interferon (IFN) and ribavirin (RBV) were associated with sometimes long-lasting and severe side-effects and thus their indication had to be carefully evaluated...
2016: Journal of Virus Eradication
Andrew Hill, Thomas Dauncey, Jake Levi, Katherine Heath, Carmen Pérez Casas
OBJECTIVES: Diagnosis and treatment of HIV-infected mothers significantly lower rates of mother-to-child transmission (MTCT) of HIV. Early infant diagnosis (EID) is required to monitor success of prevention of MTCT (pMTCT) programmes. Our aim was to compare rates of MTCT, EID and pMTCT in countries with generalised epidemics. METHODS: The UNAIDSinfo database includes country-level information on epidemic size, prevalence of HIV infection, EID rates and pMTCT coverage...
2015: Journal of Virus Eradication
Ketty Gianesin, Raffaella Petrara, Riccardo Freguja, Marisa Zanchetta, Carlo Giaquinto, Anita De Rossi
A body of evidence indicates that a threshold level of the virus is required to establish systemic and persistent HIV infection in the host and that this level depends on virus-host interactions. Mother-to-child transmission (MTCT) of HIV is the main source of paediatric HIV infection and occurs when the host's immune system is still developing. Thus, innate resistance and immunity, rather than adaptive immune response, may be the main drivers in restricting the establishment of HIV reservoirs and the long-lived persistence of HIV infection in infants...
2015: Journal of Virus Eradication
Malgorzata Pawlowska, Anna Pniewska, Malgorzata Pilarczyk, Dorota Kozielewicz, Krzysztof Domagalski
INTRODUCTION: An appropriate management of HBV infection is the best strategy to finally reduce the total burden of HBV infection. Mother-to-child transmission (MTCT) is responsible for more than one third of chronic HBV infections worldwide. Because HBV infection in infancy or early childhood often leads to chronic infection, appropriate prophylaxis and management of HBV in pregnancy is crucial to prevent MTCT. AREAS COVERED: The prevention of HBV vertical transmission is a complex task and includes: universal HBV screening of pregnant women, administration of antivirals in the third trimester of pregnancy in women with high viral load and passive-active HBV immunoprophylaxis with hepatitis B vaccine and hepatitis B immune globulin in newborns of all HBV infected women...
October 2016: Expert Opinion on Drug Safety
Martina Ceckova, Josef Reznicek, Zuzana Ptackova, Lukas Cerveny, Fabian Müller, Marian Kacerovsky, Martin F Fromm, Jocelyn D Glazier, Frantisek Staud
Lamivudine is one of the antiretroviral drugs of choice for the prevention of mother-to-child transmission (MTCT) in HIV-positive women. In this study, we investigated the relevance of drug efflux transporters P-glycoprotein (P-gp) (MDR1 [ABCB1]), BCRP (ABCG2), MRP2 (ABCC2), and MATE1 (SLC47A1) for the transmembrane transport and transplacental transfer of lamivudine. We employed in vitro accumulation and transport experiments on MDCK cells overexpressing drug efflux transporters, in situ-perfused rat term placenta, and vesicular uptake in microvillous plasma membrane (MVM) vesicles isolated from human term placenta...
September 2016: Antimicrobial Agents and Chemotherapy
Gregory A Aarons, David H Sommerfeld, Benjamin H Chi, Echezona E Ezeanolue, Rachel Sturke, Laura Guay, George K Siberry
OBJECTIVE: Although tremendous gains have been made to reduce mother-to-child HIV transmission (MTCT) globally, evidence-based practice implementation remains inconsistent in sub-Saharan Africa. We sought to identify the key domains for effective prevention of MTCT (PMTCT) implementation, using a participatory mixed-methods approach. METHODS: Participants were members of the NIH-PEPFAR PMTCT Implementation Science Alliance (ISA), a platform of researchers, public-health practitioners, policymakers, and donors supported through NIH/PEPFAR...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
L Myer, T K Phillips, J A McIntyre, N-Y Hsiao, G Petro, A Zerbe, J Ramjith, L-G Bekker, E J Abrams
OBJECTIVES: Maternal HIV viral load (VL) drives mother-to-child HIV transmission (MTCT) risk but there are few data from sub-Saharan Africa, where most MTCT occurs. We investigated VL changes during pregnancy and MTCT following antiretroviral therapy (ART) initiation in Cape Town, South Africa. METHODS: We conducted a prospective study of HIV-infected women initiating ART within routine antenatal services in a primary care setting. VL measurements were taken before ART initiation and up to three more times within 7 days postpartum...
June 28, 2016: HIV Medicine
H Buxmann, A Reitter, S Bapistella, M Stürmer, C Königs, H Ackermann, F Louwen, P Bader, R L Schlößer, A M Willasch
BACKGROUND: Maternal CD4+ cell microchimerism may be greater after caesarean section compared to spontaneous vaginal delivery and could cause mother-to-child transmission (MTCT) in HIV-exposed newborns. AIMS: To evaluate maternal CD4+ cell microchimerism in HIV-exposed newborns after spontaneous vaginal delivery or caesarean section. STUDY DESIGN AND SUBJECTS: In this prospective single-centre study, neonates whose mothers were infected with HIV and had normal MTCT risk according to the German Austrian Guidelines were considered for study enrolment...
July 2016: Early Human Development
Rangsima Lolekha, Sarawut Boonsuk, Tanarak Plipat, Michael Martin, Chaweewan Tonputsa, Niramon Punsuwan, Thananda Naiwatanakul, Kulkanya Chokephaibulkit, Hansa Thaisri, Praphan Phanuphak, Suchada Chaivooth, Sumet Ongwandee, Benjamas Baipluthong, Wachira Pengjuntr, Sopon Mekton
Thailand experienced a generalized human immunodeficiency virus (HIV) epidemic during the 1990s. HIV prevalence among pregnant women was 2.0% and the mother-to-child transmission (MTCT) rate was >20% (1-3). In June 2016, Thailand became the first country in Asia to validate the elimination of MTCT by meeting World Health Organization (WHO) targets. Because Thailand's experience implementing a successful prevention of MTCT program might be instructive for other countries, Thailand's prevention of MTCT interventions, outcomes, factors that contributed to success, and challenges that remain were reviewed...
2016: MMWR. Morbidity and Mortality Weekly Report
Kara Jensen, Rafiq Nabi, Koen K A Van Rompay, Spencer Robichaux, Jeffrey D Lifson, Michael Piatak, William R Jacobs, Glenn Fennelly, Don Canfield, Katie R Mollan, Michael G Hudgens, Michelle H Larsen, Angela M Amedee, Pamela A Kozlowski, Kristina De Paris
UNLABELLED: Despite significant progress in reducing peripartum mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) with antiretroviral therapy (ART), continued access to ART throughout the breastfeeding period is still a limiting factor, and breast milk exposure to HIV accounts for up to 44% of MTCT. As abstinence from breastfeeding is not recommended, alternative means are needed to prevent MTCT of HIV. We have previously shown that oral vaccination at birth with live attenuated Mycobacterium tuberculosis strains expressing simian immunodeficiency virus (SIV) genes safely induces persistent SIV-specific cellular and humoral immune responses both systemically and at the oral and intestinal mucosa...
August 15, 2016: Journal of Virology
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