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Hiv Perinatal Transmission

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https://www.readbyqxmd.com/read/27864000/timing-of-initiation-of-antiretroviral-therapy-and-adverse-pregnancy-outcomes-a-systematic-review-and-meta-analysis
#1
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...
November 15, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27807792/emtonjeni-a-structural-intervention-to-integrate-sexual-and-reproductive-health-into-public-sector-hiv-care-in-cape-town-south-africa-results-of-a-phase-ii-study
#2
J E Mantell, D Cooper, T M Exner, J Moodley, S Hoffman, L Myer, C-S Leu, D Bai, E A Kelvin, K Jennings, Z A Stein, D Constant, V Zweigenthal, N Cishe, N Nywagi
Integration of sexual and reproductive health within HIV care services is a promising strategy for increasing access to family planning and STI services and reducing unwanted pregnancies, perinatal HIV transmission and maternal and infant mortality among people living with HIV and their partners. We conducted a Phase II randomized futility trial of a multi-level intervention to increase adherence to safer sex guidelines among those wishing to avoid pregnancy and adherence to safer conception guidelines among those seeking conception in newly-diagnosed HIV-positive persons in four public-sector HIV clinics in Cape Town...
November 2, 2016: AIDS and Behavior
https://www.readbyqxmd.com/read/27806243/benefits-and-risks-of-antiretroviral-therapy-for-perinatal-hiv-prevention
#3
Mary G Fowler, Min Qin, Susan A Fiscus, Judith S Currier, Patricia M Flynn, Tsungai Chipato, James McIntyre, Devasena Gnanashanmugam, George K Siberry, Anne S Coletti, Taha E Taha, Karin L Klingman, Francis E Martinson, Maxensia Owor, Avy Violari, Dhayendre Moodley, Gerhard B Theron, Ramesh Bhosale, Raziya Bobat, Benjamin H Chi, Renate Strehlau, Pendo Mlay, Amy J Loftis, Renee Browning, Terence Fenton, Lynette Purdue, Michael Basar, David E Shapiro, Lynne M Mofenson
Background Randomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking. Methods We randomly assigned HIV-infected women at 14 or more weeks of gestation with CD4 counts of at least 350 cells per cubic millimeter to zidovudine and single-dose nevirapine plus a 1-to-2-week postpartum "tail" of tenofovir and emtricitabine (zidovudine alone); zidovudine, lamivudine, and lopinavir-ritonavir (zidovudine-based ART); or tenofovir, emtricitabine, and lopinavir-ritonavir (tenofovir-based ART)...
November 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27801374/incidence-and-risk-factors-for-herpes-simplex-virus-type-2-seroconversion-among-pregnant-women-in-uganda-a-prospective-study
#4
Sarah Nakubulwa, Dan K Kaye, Freddie Bwanga, Nazarius Mbona Tumwesigye, Edith Nakku-Joloba, Florence M Mirembe
INTRODUCTION: Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission. HSV-2 seroconversion occurs within four weeks of HSV-2 acquisition. There was neither documented incidence nor risk factors for HSV-2 seroconversion during pregnancy in Uganda. The objective of this study was to determine the incidence and risk factors for HSV-2 seroconversion among pregnant women in Mulago Hospital, Uganda. METHODOLOGY: A prospective study of 200 consenting HSV-2-negative women between 26 and 28 weeks of gestation was done between November 2013 and October 2014...
October 31, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27795784/-seroprevalence-of-hbsag-in-pregnant-women-in-central-morocco
#5
Mohammed Sbiti, Hanane Khalki, Imane Benbella, Lhoussaine Louzi
Maternal-fetal transmission of hepatitis B virus (HBV) is a global public health problem leading to the implementation of strengthened prevention measures. Viral replication in HIV-positive mother, assessed based on HBeAg positivity and the rate of viral load, determines the contamination risk which is very important during perinatal period. Mothers with chronic HBV are a real reservoir of vertical transmission of this infection. This is a prospective investigation of 1120 pregnant Moroccan women aiming to study the seroprevalence of HBsAg which was 2...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27760284/cervical-viral-infections-among-asymptomatic-bulgarian-women
#6
Jeni Staykova, Tanja Belovska, Ayla Murad, Sevinch Kakid, Aneta Nacheva, Evelina Shikova
AIM: Although sexually transmitted viral infections are significant and increasing public health concern, little is known about their prevalence among Bulgarian women. The aim of this study was to investigate cervical viral infections in asymptomatic women. METHODS: The study group included 52 randomly selected asymptomatic female volunteers from Bulgarian border town Kardzhali. Cervical specimens were tested by real-time PCR for human papillomaviruses (HPV), herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV)...
September 2016: Central European Journal of Public Health
https://www.readbyqxmd.com/read/27752868/perinatal-depression-among-hiv-infected-women-in-kwazulu-natal-south-africa-prenatal-depression-predicts-lower-rates-of-exclusive-breastfeeding
#7
Emily L Tuthill, Jennifer A Pellowski, Sera L Young, Lisa M Butler
Exclusive breastfeeding (EBF) provides infants with optimal nutrition, and together with appropriate antiretroviral therapy has also been shown to decrease mother-to-child transmission of HIV from 45 to less than 1 %. However, rates of EBF are particularly low in South Africa, where rates of HIV are some of the highest in the world. Although perinatal depression has been identified as a potential barrier to EBF, little is known about its impact on EBF among HIV-infected women. A cohort study was conducted as part of a pilot randomized controlled trial (RCT) examining the effect of an Information, Motivation and Behavioral skills-based intervention promoting EBF among South African women living with HIV in their third trimester (28-42 weeks) of pregnancy...
October 17, 2016: AIDS and Behavior
https://www.readbyqxmd.com/read/27749662/perinatal-antiretroviral-exposure-and-prevented-mother-to-child-hiv-infections-in-the-era-of-antiretroviral-prophylaxis-in-the-united-states-1994-2010
#8
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
https://www.readbyqxmd.com/read/27716731/health-and-survival-of-hiv-perinatally-exposed-but-uninfected-children-born-to-hiv-infected-mothers
#9
Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/27658693/hepatitis-b-viral-load-response-to-two-antiviral-regimens-tenofovir-lamivudine-vs-lamivudine-in-hiv-and-hbv-co-infected-pregnant-women-in-guangxi-china-the-tenofovir-in-pregnancy-tip-study
#10
Liming Wang, Jeffrey Wiener, Marc Bulterys, Xiaoyu Wei, Lili Chen, Wei Liu, Shujia Liang, Colin Shepard, Linhong Wang, Ailing Wang, Fujie Zhang, Athena P Kourtis
BACKGROUND:  There is limited information on HBV-antiviral therapy among HIV/HBV co-infected pregnant women. METHODS:  Phase II randomized controlled trial of a regimen containing tenofovir (TDF) /lamivudine (3TC), versus 3TC, in HIV/HBV co-infected pregnant women in China. The HBV virological response was compared in study arms (Clinical Trials registration: #NCT01125696). RESULTS:  Median decline of HBV DNA was 2.60 log10 copies/ml in the TDF-3TC arm; 2...
September 22, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27658440/a-randomized-safety-and-pharmacokinetic-trial-of-daily-tenofovir-1-gel-in-term-and-near-term-pregnancy
#11
Richard H Beigi, Lisa M Noguchi, Elizabeth Montgomery, Joseph Biggio, Craig W Hendrix, Mark A Marzinke, James Y Dai, Jason Pan, Ratiya Kunjara Na Ayudhya, Jill L Schwartz, Karen Isaacs, Jeanna M Piper, D Heather Watts
INTRODUCTION: Vaginal tenofovir (TFV) 1% gel may reduce incident HIV-1 and herpes simplex virus 2 infection. Pregnancy may increase risk of HIV acquisition, and incident HIV in pregnancy potentiates perinatal HIV transmission. Our objective was to investigate the safety and pharmacokinetics of seven days of TFV 1% vaginal gel in term and near-term pregnancy. METHODS: Ninety-eight healthy pregnant women, stratified to a term cohort followed by a near-term cohort, were enrolled into a 2:1 randomized, double-blinded, placebo-controlled trial...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27630001/systematic-review-with-meta-analysis-the-risk-of-mother-to-child-transmission-of-hepatitis-b-virus-infection-in-sub-saharan-africa
#12
E Keane, A L Funk, Y Shimakawa
BACKGROUND: The risk of mother-to-child transmission of hepatitis B virus (HBV) has been quoted as 70-90% among women positive for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), and 5-30% among HBsAg-positive HBeAg-negative women. These risks are derived from Asia; little is known about sub-Saharan Africa. AIM: To determine the risk of mother-to-child transmission in sub-Saharan Africa, according to maternal HBeAg and type of prophylaxis. METHODS: We searched Medline, Global Health, Embase, African Journals Online and African Index Medicus...
November 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27595131/sexual-behavior-and-knowledge-among-adolescents-with-perinatally-acquired-human-immunodeficiency-virus-infection-compared-to-hiv-uninfected-adolescents-at-an-urban-tertiary-center-in-new-jersey
#13
Ashlesha Kaushik, Carol Pineda, Helen Kest
Background. Sexual behaviors and knowledge among PHIV-infected (PHIV(+)) adolescents in comparison with HIV-uninfected youths are not well understood and continue to be studied actively. Objective. To compare sexual behavior and sexual knowledge of PHIV(+) and HIV-uninfected adolescents at an urban, tertiary-care center in New Jersey. Study Design. Modified Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance questionnaire was administered to PHIV(+) and HIV-uninfected adolescents to assess and compare sexual behavior and knowledge over a 1-year-period...
2016: International Journal of Reproductive Medicine
https://www.readbyqxmd.com/read/27594857/linking-susceptibility-to-infectious-diseases-to-immune-system-abnormalities-among-hiv-exposed-uninfected-infants
#14
REVIEW
Candice Ruck, Brian A Reikie, Arnaud Marchant, Tobias R Kollmann, Fatima Kakkar
HIV-exposed uninfected (HEU) infants experience increased overall mortality from infectious causes when compared to HIV-unexposed uninfected (HU) infants. This is the case in both the resource-rich and resource-limited settings. Here, we explore the concept that specific types of infectious diseases that are more common among HEU infants could provide clues as to the potential underlying immunological abnormalities. The most commonly reported infections in HEU vs. HU infants are caused by encapsulated bacteria, suggesting the existence of a less effective humoral (antibody, complement) immune response...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27573084/contraception-for-hiv-infected-adolescents
#15
Athena P Kourtis, Ayesha Mirza
Access to high-quality reproductive health care is important for adolescents and young adults with HIV infection to prevent unintended pregnancies, sexually transmitted infections, and secondary transmission of HIV to partners and children. As perinatally HIV-infected children mature into adolescence and adulthood and new HIV infections among adolescents and young adults continue to occur in the United States, medical providers taking care of such individuals often face issues related to sexual and reproductive health...
September 2016: Pediatrics
https://www.readbyqxmd.com/read/27571541/-i-definitely-want-grandbabies-caregivers-of-adolescents-with-perinatally-acquired-hiv-reflect-on-dating-and-childbearing
#16
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
https://www.readbyqxmd.com/read/27562873/drug-drug-interactions-effectiveness-and-safety-of-hormonal-contraceptives-in-women-living-with-hiv
#17
REVIEW
Kimberly K Scarsi, Kristin M Darin, Catherine A Chappell, Stephanie M Nitz, Mohammed Lamorde
Family planning options, including hormonal contraceptives, are essential for improving reproductive health among the more than 17 million women living with HIV worldwide. For these women, prevention of unintended pregnancy decreases maternal and child mortality, as well as reduces the risk of perinatal HIV transmission. Similarly, treatment of HIV with antiretroviral therapy (ART) is essential for reducing morbidity and mortality among HIV-positive individuals, as well as preventing HIV transmission between sexual partners or from mother to child...
November 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27540363/etravirine-pharmacokinetics-in-hiv-infected-pregnant-women
#18
Nikki Mulligan, Stein Schalkwijk, Brookie M Best, Angela Colbers, Jiajia Wang, Edmund V Capparelli, José Moltó, Alice M Stek, Graham Taylor, Elizabeth Smith, Carmen Hidalgo Tenorio, Nahida Chakhtoura, Marjo van Kasteren, Courtney V Fletcher, Mark Mirochnick, David Burger
BACKGROUND: The study goal was to describe etravirine pharmacokinetics during pregnancy and postpartum in HIV-infected women. METHODS: IMPAACT P1026s and PANNA are on-going, non-randomized, open-label, parallel-group, multi-center phase-IV prospective studies in HIV-infected pregnant women. Intensive steady-state 12-h pharmacokinetic profiles were performed from 2nd trimester through postpartum. Etravirine was measured at two labs using validated ultra performance liquid chromatography (detection limits: 0...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27504071/management-of-hiv-infection-during-pregnancy-in-the-united-states-updated-evidence-based-recommendations-and-future-potential-practices
#19
REVIEW
Bassam H Rimawi, Lisa Haddad, Martina L Badell, Rana Chakraborty
All HIV-infected women contemplating pregnancy should initiate combination antiretroviral therapy (cART), with a goal to achieve a maternal serum HIV RNA viral load beneath the laboratory level of detection prior to conceiving, as well as throughout their pregnancy. Successfully identifying HIV infection during pregnancy through screening tests is essential in order to prevent in utero and intrapartum transmission of HIV. Perinatal HIV transmission can be less than 1% when effective cART, associated with virologic suppression of HIV, is given during the ante-, intra-, and postpartum periods...
2016: Infectious Diseases in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27452341/mitochondrial-compromise-in-3-year-old-patas-monkeys-exposed-in-utero-to-human-equivalent-antiretroviral-therapies
#20
Yongmin Liu, Eunwoo Shim Park, Alexander T Gibbons, Eric D Shide, Rao L Divi, Ruth A Woodward, Miriam C Poirier
Antiretroviral (ARV) drug therapy, given during pregnancy for prevention of mother-to-child transmission of human immunodeficiency virus 1 (HIV-1), induces fetal mitochondrial dysfunction in some children. However, the persistence/reversibility of that dysfunction is unclear. Here we have followed Erythrocebus patas (patas) monkey offspring for up to 3 years of age (similar in development to a 15-year old human) after exposure of the dams to human-equivalent in utero ARV exposure protocols. Pregnant patas dams (3-5/exposure group) were given ARV drug combinations that included zidovudine (AZT)/lamivudine (3TC)/abacavir (ABC), or AZT/3TC/nevirapine (NVP), for the last 10 weeks (50%) of gestation...
August 2016: Environmental and Molecular Mutagenesis
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