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Perinatal Transmission hiv

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https://www.readbyqxmd.com/read/29336508/national-audit-of-perinatal-hiv-infections-in-the-uk-2006-2013-what-lessons-can-be-learnt
#1
H Peters, C Thorne, P A Tookey, L Byrne
OBJECTIVES: The aim of the study was to investigate circumstances surrounding perinatal transmissions of HIV (PHIVs) in the UK. METHODS: The National Study of HIV in Pregnancy and Childhood conducts comprehensive surveillance of all pregnancies in women diagnosed with HIV infection and their infants in the UK; reports of all HIV-diagnosed children are also sought, regardless of country of birth. Children with PHIV born in 2006-2013 and reported by 2014 were included in an audit, with additional data collection via telephone interviews with clinicians involved in each case...
January 16, 2018: HIV Medicine
https://www.readbyqxmd.com/read/29335895/pharmacokinetics-antiviral-activity-and-safety-of-rilpivirine-in-pregnant-women-with-hiv-1-infection-results-of-a-phase-3b-multicenter-open-label-study
#2
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
https://www.readbyqxmd.com/read/29319636/optimal-antiretroviral-prophylaxis-in-infants-at-high-risk-of-acquiring-hiv-a-systematic-review
#3
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
https://www.readbyqxmd.com/read/29315112/what-is-new-in-perinatal-hiv-prevention
#4
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/29303121/maternal-and-obstetric-complications-among-hiv-infected-women-treated-with-highly-active-antiretroviral-treatment-at-a-regional-hospital-in-durban-south-africa
#5
H M Sebitloane, J Moodley
INTRODUCTION: HIV is the leading cause of maternal deaths in resource-poor countries. The use of highly active antiretroviral treatment (HAART) has been shown to almost eliminate vertical transmission and improve maternal health outcomes. Its effect on direct obstetric conditions has not been well documented. METHODS: We conducted a retrospective study of women who delivered at a regional hospital from April 1, 2011, to April 30, 2014. We employed a stratified random selection, where the first 50 files recorded in the birth register during each calendar month were chosen, at a ratio of one HIV uninfected for every 4 infected women...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29294828/prevalence-and-correlates-of-forced-sex-as-a-self-reported-mode-of-hiv-acquisition-among-a-cohort-of-women-living-with-hiv-in-canada
#6
Carmen H Logie, Angela Kaida, Alexandra de Pokomandy, Nadia O'Brien, Pat O'Campo, Jay MacGillivray, Uzma Ahmed, Nikita Arora, Lu Wang, Shahab Jabbari, Logan Kennedy, Allison Carter, Karène Proulx-Boucher, Tracey Conway, Paul Sereda, Mona Loutfy
Gender-based violence (GBV) is a global epidemic associated with increased HIV exposure. We assessed the prevalence and correlates of HIV acquisition via forced sex among women living with HIV (WLWH) in Canada. Baseline questionnaire data were analyzed for WLWH (≥16 years) with data on self-reported mode of HIV acquisition, enrolled in a community-based cohort study in British Columbia, Ontario, and Québec. We assessed forced sex (childhood, adulthood) as a self-reported mode of HIV acquisition. Of 1,330 participants, the median age was 42 (interquartile range [IQR] = 35-50) years; 23...
July 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29283274/using-an-innovative-telehealth-model-to-support-community-providers-who-deliver-perinatal-hiv-care
#7
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
#8
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
#9
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
#10
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
#11
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/29136115/estradiol-levels-are-altered-in-human-immunodeficiency-virus-infected-pregnant-women-randomized-to-efavirenz-versus-lopinavir-ritonavir-based-antiretroviral-therapy
#12
Chloe R McDonald, Andrea L Conroy, Joel L Gamble, Eszter Papp, Michael Hawkes, Peter Olwoch, Paul Natureeba, Moses Kamya, Michael Silverman, Deborah Cohan, Catherine A Koss, Grant Dorsey, Kevin C Kain, Lena Serghides
Background: Combination antiretroviral therapy (cART) use in pregnancy has been associated with hormonal dysregulation. We performed a secondary retrospective analysis of longitudinal progesterone and estradiol levels in pregnancy using specimens from the Protease Inhibitors to Reduce Malaria Morbidity in HIV-infected Pregnant Women study, which randomized Ugandan human immunodeficiency virus (HIV)-infected ART-naive women to initiate either lopinavir/ritonavir (LPV/r)-based or efavirenz (EFV)-based cART...
November 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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
#13
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
#14
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
#15
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/28989498/two-vignettes-of-adolescent-sexual-disclosure-guidance-for-hiv-clinical-practice
#16
Bronwen Lichtenstein, Cynthia Rodgers, Lauren Eb Marefka, Marla D Hinson, Dayna Cook-Heard, Stephen D Rygiel, Marsha S Sturdevant
HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts...
January 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28988509/darunavir-for-use-in-pregnant-women-with-hiv
#17
Robert Pope, Angela Kashuba
Combination antiretroviral therapy is recommended during pregnancy to decrease the rate of HIV transmission to the baby and reduce morbidity in the mother. More than 50% of women are prescribed a protease inhibitor-based regimen during pregnancy. Darunavir was recently reclassified as a first-line protease inhibitor for use in pregnancy in the US Department of Health and Human Services Perinatal Guidelines. Areas covered: This is a brief review of the use of protease inhibitor therapy during pregnancy, and a discussion of darunavir's utility in this area...
November 14, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28969502/a-hierarchical-modeling-approach-for-assessing-the-safety-of-exposure-to-complex-antiretroviral-drug-regimens-during-pregnancy
#18
Katharine Correia, Paige L Williams
Combination antiretroviral regimens have achieved tremendous success in reducing perinatal HIV transmission, and have become standard of care in pregnant women with HIV. However, the large variety of combination antiretroviral regimens utilized in practice raises the question of whether some of these highly potent drugs pose other risks to the pregnancy or infant. While HIV-infected pregnant women are almost always exposed to multiple antiretrovirals concurrently, standard safety screening strategies typically consider each individual antiretroviral separately, which fails to account for potential confounding due to simultaneous exposure to other antiretrovirals...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28953612/new-diagnoses-of-human-immunodeficiency-virus-infection-in-the-spanish-pediatric-hiv-cohort-corispe-from-2004-to-2013
#19
Santiago Jiménez de Ory, María Isabel González-Tomé, Claudia Fortuny, Maria Jose Mellado, Pere Soler-Palacin, Matilde Bustillo, José Tomas Ramos, Maria Angeles Muñoz-Fernández, Maria Luisa Navarro
Vertical human immunodeficiency virus (HIV) infection has decreased in industrialized countries in recent decades, but there are no studies on the mechanisms of HIV transmission among infected children in Spain. Our aim was to study the characteristics and trends of diagnoses of vertically HIV-infected children in Spain from 2004 to 2013.Vertically HIV-infected children were selected if they were diagnosed from 2004 to 2013, were aged 0 to 18 years old, and were included in the Cohort of the Spanish Pediatric HIV Network (CoRISpe)...
September 2017: Medicine (Baltimore)
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
#20
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
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