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HIV-exposed infants

Olivia Falconer, Marie-Louise Newell, Christine E Jones
The success of prevention of mother to child transmission programs over the last two decades has led to an increasing number of infants who are exposed to human immunodeficiency virus (HIV), but who are not themselves infected (HIV-exposed, uninfected infants). Although the morbidity and mortality among HIV-exposed, uninfected infants is considerably lower than that among HIV-infected infants, they may remain at increased risk of infections in the first 2 years of life compared with their HIV-unexposed peers, especially in the absence of breastfeeding...
2018: Frontiers in Immunology
Sumona Chaudhury, Gloria K Mayondi, Paige L Williams, Jean Leidner, Roger Shapiro, Modiegi Diseko, Gbolahan Ajibola, Penny Holding, Vicki Tepper, Joseph Makhema, Chipo Petlo, George R Seage, Shahin Lockman, Betsy Kammerer
OBJECTIVE: Conflicting data exist regarding the impact of in utero exposure to maternal combination antiretrovirals. We compared neurodevelopmental outcomes between HIV-exposed/uninfected (HEU) children exposed in utero to 3-drug combination antiretroviral therapy (ART) versus zidovudine (ZDV) monotherapy. DESIGN: Prospective study of child neurodevelopment, nested within two cohorts of HIV-infected mothers and their children in Botswana (one observational, one interventional)...
March 15, 2018: AIDS
Kristina Adachi, Jiahong Xu, Bonnie Ank, D Heather Watts, Margaret Camarca, Lynne M Mofenson, Jose Henrique Pilotto, Esau Joao, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa M Mussi-Pinhata, Daisy Maria Machado, Mariana Ceriotto, Mariza G Morgado, Yvonne J Bryson, Valdilea G Veloso, Beatriz Grinsztejn, Mark Mirochnick, Jack Moye, Karin Nielsen-Saines
BACKGROUND: Congenital cytomegalovirus (CMV) infection (cCMV) is an important cause of hearing loss and cognitive impairment. Prior studies suggest that HIV-exposed children are at higher risk of acquiring cCMV. We assessed the presence, magnitude, and risk factors associated with cCMV among infants born to HIV-infected women, who were not receiving antiretrovirals during pregnancy. METHODS: cCMV and urinary CMV load were determined in a cohort of infants born to HIV-infected women not receiving antiretrovirals during pregnancy...
March 9, 2018: Pediatric Infectious Disease Journal
Luisa Zupin, Vania Polesello, Ludovica Segat, Anselmo Jiro Kamada, Louise Kuhn, Sergio Crovella
INTRODUCTION: Human Beta Defensin-1 (hBD-1) is a component of the innate immune system, the first line of defence against pathogens, already reported as involved in the susceptibility to HIV-1 infection and HIV-1 mother-to-child transmission (MTCT) in different populations. We investigated the role of DEFB1 gene (encoding for hBD-1) functional polymorphisms in the susceptibility to HIV-1 MTCT in a population from Zambia. METHODS: Four selected polymorphisms within DEFB1 gene, three at the 5' untranslated region (UTR), namely - 52G>A ( RS1799946 ), -44C>G ( RS1800972 ) and -20G>A ( RS11362 ) and one in the 3'UTR, c...
March 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
T Isnard, A Vincent-Rohfritsch, C Le Ray, F Goffinet, J Patkai, J Sibiude
OBJECTIVE: To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. METHODS: We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes...
February 26, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Anicet Christel Maloupazoa Siawaya, Ofilia Mvoundza Ndjindji, Eliane Kuissi Kamgaing, Amandine Mveang-Nzoghe, Chérone Nancy Mbani Mpega, Marielle Leboueny, Roselyne Kengue Boussougou, Armel Mintsa Ndong, Paulin N Essone, Joel Fleury Djoba Siawaya
Pathogen sensing and recognition through pattern recognition receptors, and subsequent production of pro-inflammatory cytokines, is the cornerstone of the innate immune system. Despite the fact that HIV-exposed uninfected (HEU) infants are prone to serious bacterial infections, no study has focused on the functionality of their bacteria recognition system. This is the first study to investigate baseline levels of three critically important immune response molecules in this population: complement component (C)-3, toll-like receptor (TLR)-4, and C-reactive protein (CRP)...
2018: Frontiers in Immunology
Reuben Mwenda, Youyi Fong, Termson Magombo, Emmanuel Saka, Dalitso Midian, Christopher Mwase, James Kandulu, Melody Wang, Rachel Thomas, Judith Sherman, Lara Vojnov
Background: In Malawi in 2014, less than 20% of HIV-exposed infants received an EID test in the first two months of life and only 30% of HIV-infected children were on ART. We, therefore, sought to understand the potential patient impact of improving timely infant diagnosis and treatment initiation through implementation of POC EID technologies in Malawi. Methods: In this observational study POC EID technologies were introduced into routine services at seven health facilities across Malawi in September 2015...
February 27, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Charles Kiyaga, Brittany Urick, Youyi Fong, Christopher Okiira, Nicolette Nabukeera-Barungi, Denis Nansera, Emmanuel Ochola, Julius Nteziyaremye, Victor Bigira, Isaac Ssewanyana, Peter Olupot-Olupot, Trevor Peter, Anisa Ghadrshenas, Lara Vojnov
INTRODUCTION: Despite notable progress towards PMTCT, only 50% of HIV-exposed infants in sub-Saharan Africa were tested within the first 2 months of life and only 30% of HIV-infected infants are on antiretroviral treatment. This study assessed HIV prevalence in infants and children receiving care at various service entry points in primary healthcare facilities in Uganda. METHODS: A total of 3600 infants up to 24 months of age were systematically enrolled and tested at four regional hospitals across Uganda...
February 2018: Journal of the International AIDS Society
Sandro Mancinelli, Maria Franca Pirillo, Giuseppe Liotta, Mauro Andreotti, Robert Mphwere, Roberta Amici, Maria Cristina Marazzi, Stefano Vella, Leonardo Palombi, Marina Giuliano
The aim of this study was to assess the immune response to HBV vaccine in HIV-exposed infants and to correlate it to HBV infection acquisition. Protective anti-HBs levels (> 10 mIU/ml) were found in 54/58 (93.2%) infants at 6 months, 126/144 (87.5%) at 12 months and 141/176 (80.1%) children at 24 months. HBV infection (7 children were HBsAg+ at Month 24) occurred also in the presence of levels above 10 mIU/ml. Our findings indicate limited impact of HIV exposure on anti-HBV immune response, but suggest that levels > 10 mIU/ml may be required to confer protection in this context...
February 10, 2018: Journal of Medical Virology
NMdu Plessis, G Ntshoe, G Reubenson, R Kularatne, L Blumberg, J Thomas, T Avenant
BACKGROUND: In low and middle-income countries, including South Africa, the epidemiology of pertussis in relation to immunisation, nutritional and HIV status is poorly described. We report on risk factors in South African children hospitalised with pertussis. METHODS: We conducted a prospective, hospital-based, sentinel surveillance programme for pertussis in Gauteng Province, South Africa. Hospitalised children (≤10 years) meeting the surveillance criteria for clinically suspected pertussis were screened and enrolled...
February 1, 2018: International Journal of Infectious Diseases: IJID
Cristhina Bonilha Huster Siegle, Cristina Dos Santos Cardoso de Sá
BACKGROUND: Exposure to HIV during pregnancy is a risks to development. Exposed child should have assessed its development since birth. Alberta Infant Motor Scale is a tool which assess gross motor skills, with easy application and low cost. Up to now, this scale had not proven its validity for the population exposed to HIV. It's necessary to compare its with a gold standard tool, Bayley scale, which assess gross and fine motor skills, has a high cost and longer application time required...
February 1, 2018: Infant Behavior & Development
Thu-Ha Dinh, Angela Mushavi, Ray W Shiraishi, Beth Tippett Barr, Shirish Balachandra, Gerald Shambira, Justice Nyakura, Sekesai Zinyowera, Mufuta Tshimanga, Owen Mugurungi, Peter H Kilmarx
Background: Preventing mother-to-child transmission of human immunodeficiency virus transmission (MTCT) depends on early initiation of antiretroviral therapy (ART). We report the 18-month MTCT risk during the transition from Option A to Option B+ in Zimbabwe, and assess whether ART preconception could eliminate MTCT in breastfeeding populations. Methods: In 2013, we consecutively recruited a nationally representative sample of 6051 infants aged 4-12 weeks and their mothers from 151 immunization clinics using a multistage stratified cluster sampling method...
February 1, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Riikka Bornhede, Sandra Soeria-Atmadja, Katarina Westling, Karin Pettersson, Lars Navér
The development of new drugs for treatment of HIV has increased the efficacy and the quality of life together with decreased unwanted side-effect for people living with HIV. The integrase inhibitor dolutegravir has in short time become part of the first-line treatment in many countries, but is not a recommended first-line drug in pregnancy. As there are few publications of dolutegravir use during pregnancy, we found it valuable to analyze the Stockholm pregnancy cohort. A retrospective analysis of all pregnant women and their infants exposed to dolutegravir at Karolinska University Hospital, 2014-August 2017...
February 2, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Michelle M Gill, Heather J Hoffman, Dieudonne Ndatimana, Placidie Mugwaneza, Laura Guay, Gilles F Ndayisaba, Emily A Bobrow, Anita Asiimwe, Lynne M Mofenson
Lifelong antiretroviral therapy (ART) provision to all pregnant HIV-positive women ("Option B+") has been recommended by the World Health Organization since 2013, but there remain limited data on the effects of Option B+ on long-term HIV-free survival in breastfeeding HIV-exposed infants. The Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study enrolled HIV-positive women from the third trimester of pregnancy to 2 weeks postpartum in 14 heath facilities implementing Option B+ in Kigali, Rwanda...
December 2017: Medicine (Baltimore)
Megan S McHenry, Carole I McAteer, Eren Oyungu, Brenna C McDonald, Chris B Bosma, Philani B Mpofu, Andrew R Deathe, Rachel C Vreeman
CONTEXT: HIV-infected (HIV+) children have worse neurodevelopmental outcomes compared with HIV-uninfected children. However, little is known regarding the differences in neurodevelopment between young HIV+ children, HIV-exposed but uninfected (HEU) children, and HIV-unexposed and uninfected (HUU) children. OBJECTIVE: To systematically review and meta-analyze data on neurodevelopmental performance between young HIV+, HEU, and HUU children. DATA SOURCES: We systematically searched the following electronic bibliographic databases: Ovid Medline, Embase, PsycINFO, Education Resources Information Center, and the Cochrane Database of Systematic Reviews...
January 26, 2018: Pediatrics
Joshua A Eudailey, Maria L Dennis, Morgan E Parker, Bonnie L Phillips, Tori N Huffman, Camden P Bay, Michael G Hudgens, Roger W Wiseman, Justin J Pollara, Genevieve G Fouda, Guido Ferrari, David J Pickup, Pamela A Kozlowski, Koen K A Van Rompay, Kristina De Paris, Sallie R Permar
Mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) contributes to an estimated 150,000 new infections annually. Maternal vaccination has proven safe and effective at mitigating the impact of other neonatal pathogens and is one avenue toward generating the potentially protective immune responses necessary to inhibit HIV-1 infection of infants through breastfeeding. In the present study, we tested the efficacy of a maternal vaccine regimen consisting of a modified vaccinia virus Ankara (MVA) 1086...
January 2018: MSphere
Methuselah Muhindo Kahungu, Julius Kiwanuka, Frank Kaharuza, Rhoda K Wanyenze
BACKGROUND: East and South Africa contributes 59% of all pediatric HIV infections globally. In Uganda, HIV prevalence among HIV exposed infants was estimated at 5.3% in 2014. Understanding the remaining bottlenecks to elimination of mother-to-child transmission (eMTCT) is critical to accelerating efforts towards eMTCT. This study determined factors associated with HIV positive sero-status among exposed infants attending mother-baby care clinics in rural Kasese so as to inform enhancement of interventions to further reduce MTCT...
January 16, 2018: BMC Public Health
Olayemi Osiyemi, Salih Yasin, Carmen Zorrilla, Ceyhun Bicer, Vera Hillewaert, Kimberley Brown, Herta M Crauwels
INTRODUCTION: Physiologic changes during pregnancy may impact the pharmacokinetics of drugs. In addition, efficacy and safety/tolerability concerns have been identified for some antiretroviral agents. METHODS: Human immunodeficiency virus (HIV)-1-infected pregnant women (18-26 weeks gestation) receiving the non-nucleoside reverse transcriptase inhibitor rilpivirine 25 mg once daily were enrolled in this phase 3b, open-label study examining the impact of pregnancy on the pharmacokinetics of rilpivirine when it is given in combination with other antiretroviral agents...
January 15, 2018: Infectious Diseases and Therapy
Silvia Baroncelli, Clementina M Galluzzo, Giuseppe Liotta, Mauro Andreotti, Fausto Ciccacci, Sandro Mancinelli, Victor T Tolno, Jane Gondwe, Roberta Amici, Maria C Marazzi, Stefano Vella, Marina Giuliano, Leonardo Palombi, Lucia Palmisano
PROBLEM: Data on soluble CD14 (sCD14) during pregnancy and lactation are scarce. We assessed the levels of sCD14 in plasma and breastmilk of Malawian HIV-positive women and evaluated the possible association with morbidity and mortality in the HIV-exposed children. METHOD OF STUDY: One hundred and forty-nine mother/child pairs were studied. Women received antiretroviral therapy from 26 weeks of gestation to at least 6 months of exclusive breastfeeding. sCD14 concentrations were determined using an enzyme-linked immunosorbent assay...
January 11, 2018: American Journal of Reproductive Immunology: AJRI
Sara Beste, Shaffiq Essajee, George Siberry, Alisse Hannaford, Jasmeen Dara, Nandita Sugandhi, Martina Penazzato
INTRODUCTION: The risk of perinatal HIV infection can be dramatically reduced through maternal antiretroviral (ARV) therapy and infant ARV postnatal prophylaxis. The 2013 World Health Organization guidelines recommended 4-6 weeks of nevirapine or zidovudine as postnatal prophylaxis, with possible extension to 12 weeks for high-risk breastfed infants. A systematic review was undertaken to determine if there is evidence for the World Health Organization to recommend enhanced or extended prophylaxis for high-risk infants...
February 2018: Pediatric Infectious Disease Journal
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