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Hiv Perinatal Transmission

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https://www.readbyqxmd.com/read/28723871/optimal-anti-retroviral-prophylaxis-in-infants-at-high-risk-of-acquiring-human-immunodeficiency-virus-a-systematic-review
#1
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 therapy (ART) and infant antiretroviral (ARV) postnatal prophylaxis. The 2013 WHO guidelines recommended four to six weeks of nevirapine or zidovudine as post-natal 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 WHO to recommend enhanced or extended prophylaxis for high-risk infants...
July 18, 2017: Pediatric Infectious Disease Journal
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
#2
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 17, 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
#3
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/28600331/does-maternal-hsv-2-coinfection-increase-mother-to-child-transmission-of-hiv-a-systematic-review
#4
REVIEW
Vishalini Sivarajah, Kevin Venus, Mark H Yudin, Kellie E Murphy, Steven A Morrison, Darrell Hs Tan
BACKGROUND: Reducing HIV mother-to-child transmission (MTCT) is critical to ending the HIV pandemic. Reports suggest that herpes simplex virus-2 (HSV-2), a common coinfection in HIV-infected individuals, is associated with increased MTCT, but results have been conflicting. We conducted a systematic review of observational studies to quantify the magnitude of this relationship (PROSPERO no. CRD42016043315). METHODS: We searched Medline (1981 to June week 3, 2016), EMBASE (1981 to week 26, 2016), relevant conferences (2013-2016) and bibliographies of identified studies for cohort and case-control studies enrolling HIV-positive women during pregnancy or peripartum that quantified the effect of HSV-2 infection on MTCT...
June 9, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28595510/young-adults-hiv-1-infected-by-vertical-transmission-in-southern-brazil-clinical-demographic-and-virological-features
#5
Beatris M Martin, Jucélia S Santos, Fernanda V Scapinello, Clea El Ribeiro, Monica M Gomes-da-Silva, Sonia M Raboni
Combination antiretroviral therapy promotes longer life expectancy, making it possible for perinatally HIV-infected patients to achieve adulthood. Past therapy was not always optimized, suggesting that virological and host features may also play a role in survival. The aim of this study is to describe characteristics of HIV disease progression associated with virological features in adolescents perinatally that were HIV infected. A case series was conducted including 81 patients that were in follow-up at Hospital de Clínicas/Universidade Federal do Paraná, Curitiba, Brazil...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28595298/lowered-rilpivirine-exposure-during-third-trimester-of-pregnancy-in-hiv-1-positive-women
#6
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
#7
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/28489226/transition-of-care-for-youth-with-hiv
#8
Mary Ellen Acree
Remarkable advances have been made in the treatment of HIV. Despite progress in reducing perinatal HIV transmission, there is a growing number of adolescents and emerging adults with HIV who will require transfer of care from pediatric to adult providers. Adolescents with HIV have poorer retention in care and viral suppression compared to other age groups with HIV. Barriers to successful care of youth with HIV include mental health disorders, poor medication adherence, socioeconomic instability, and HIV-related stigma...
May 1, 2017: Pediatric Annals
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
#9
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/28481770/elective-cesarean-section-for-women-living-with-hiv-a-systematic-review-of-risks-and-benefits
#10
Caitlin E Kennedy, Ping T Yeh, Shristi Pandey, Ana P Betran, Manjulaa Narasimhan
OBJECTIVE AND DESIGN: To inform WHO guidelines, we conducted a systematic review and meta-analysis to assess maternal and perinatal outcomes comparing cesarean section (c-section) before labor and rupture of membranes [elective c-section (ECS)] with other modes of delivery for women living with HIV. METHODS: We searched PubMed, CINAHL, Embase, CENTRAL, and previous reviews to identify published trials and observational studies through October 2015. Results were synthesized using random-effects meta-analysis, stratifying for combination antiretroviral therapy (cART), CD4/viral load (VL), delivery at term, and low-income/middle-income countries...
July 17, 2017: AIDS
https://www.readbyqxmd.com/read/28458735/features-of-maternal-hiv-1-associated-with-lack-of-vertical-transmission
#11
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/28452911/the-effect-of-hiv-centered-obstetric-care-on-perinatal-outcomes-among-a-cohort-of-women-living-with-hiv
#12
Anna M Powell, Julia M DeVita, Amartha Ogburu-Ogbonnaya, Andrea Peterson, Gweneth B Lazenby
BACKGROUND: Elimination of perinatal transmission is possible but limited by missed care opportunities. Our objective was to investigate the effects of HIV-centered obstetric care (HCC) on missed care opportunities and perinatal HIV transmission in 2 obstetric cohorts at our institution from 2000 to 2014. METHODS: This was a retrospective cohort study of HIV-exposed mother-infant pairs delivering from 2000 to 2014, analyzed according to SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guidelines...
August 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28446232/continuous-quality-improvement-interventions-to-improve-long-term-outcomes-of-antiretroviral-therapy-in-women-who-initiated-therapy-during-pregnancy-or-breastfeeding-in-the-democratic-republic-of-congo-design-of-an-open-label-parallel-group-randomized-trial
#13
Marcel Yotebieng, Frieda Behets, Bienvenu Kawende, Noro Lantoniaina Rosa Ravelomanana, Martine Tabala, Emile W Okitolonda
BACKGROUND: Despite the rapid adoption of the World Health Organization's 2013 guidelines, children continue to be infected with HIV perinatally because of sub-optimal adherence to the continuum of HIV care in maternal and child health (MCH) clinics. To achieve the UNAIDS goal of eliminating mother-to-child HIV transmission, multiple, adaptive interventions need to be implemented to improve adherence to the HIV continuum. METHODS: The aim of this open label, parallel, group randomized trial is to evaluate the effectiveness of Continuous Quality Improvement (CQI) interventions implemented at facility and health district levels to improve retention in care and virological suppression through 24 months postpartum among pregnant and breastfeeding women receiving ART in MCH clinics in Kinshasa, Democratic Republic of Congo...
April 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28405623/bcg-vaccination-induces-hiv-target-cell-activation-in-hiv-exposed-infants-in-a-randomized-trial
#14
Melanie A Gasper, Anneke C Hesseling, Isaac Mohar, Landon Myer, Tali Azenkot, Jo-Ann S Passmore, Willem Hanekom, Mark F Cotton, I Nicholas Crispe, Donald L Sodora, Heather B Jaspan
BACKGROUND. Bacillus Calmette-Guérin (BCG) vaccine is administered at birth to protect infants against tuberculosis throughout Africa, where most perinatal HIV-1 transmission occurs. We examined whether BCG vaccination alters the levels of activated HIV target T cells in HIV-exposed South African infants. METHODS. HIV-exposed infants were randomized to receive routine (at birth) or delayed (at 8 weeks) BCG vaccination. Activated and CCR5-expressing peripheral blood CD4(+) T cell, monocyte, and NK cell frequencies were evaluated by flow cytometry and immune gene expression via PCR using Biomark (Fluidigm)...
April 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28398096/advances-in-therapy-for-the-prevention-of-hiv-transmission-from-mother-to-child
#15
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/28369278/cytomegalovirus-urinary-shedding-in-hiv-infected-pregnant-women-and-congenital-cytomegalovirus-infection
#16
Kristina Adachi, Jiahong Xu, Bonnie Ank, D Heather Watts, Lynne M Mofenson, Jose Henrique Pilotto, Esau Joao, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa M Mussi-Pinhata, Glenda Gray, Gerhard Theron, Mariza G Morgado, Yvonne J Bryson, Valdilea G Veloso, Jeffrey D Klausner, Jack Moye, Karin Nielsen-Saines
Background: Cytomegalovirus (CMV) urinary shedding in HIV-infected pregnant women was evaluated to determine whether it poses an increased risk for congenital CMV infection (cCMV). Methods: A subset of mother-infant pairs enrolled in the perinatal NICHD HPTN 040 study (distinguished by no antiretroviral use before labor) was evaluated. Maternal and infant urines were tested by qualitative real-time polymerase chain reaction (RT-PCR) for CMV DNA with quantitative RT-PCR performed on positive specimens...
March 22, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28367745/the-intersection-of-abandonment-hiv-positive-status-and-residential-care-for-a-group-of-perinatally-infected-adolescents
#17
REVIEW
Jeanette Schmid, Jenita Chiba
Although anti-retroviral treatments have significantly reduced the incidence of mother-to-child transmission of HIV and AIDS, there remains, for the foreseeable future, a group of adolescents who have been perinatally infected. Noting the paucity of information regarding the impact of paediatric AIDS and its intersection with residential care, this paper investigates the lived realities of 20 South African adolescents who were vertically infected with HIV and AIDS, were abandoned, and have been raised in residential care...
March 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28361508/delivering-safer-conception-services-to-hiv-serodiscordant-couples-in-kenya-perspectives-from-healthcare-providers-and-hiv-serodiscordant-couples
#18
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
#19
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
#20
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
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