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Hiv Perinatal Transmission

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
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
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
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
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
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
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
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
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
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
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
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
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
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
Dominika L Seidman, Shannon Weber, Maria Teresa Timoney, Karishma K Oza, Elizabeth Mullins, Deborah L Cohan, Rodney L Wright
BACKGROUND: Pregnancy may increase a woman's susceptibility to HIV. Maternal HIV acquisition during pregnancy and lactation is associated with increased perinatal and lactational HIV transmission. There are no published reports of preexposure prophylaxis use after the first trimester of pregnancy or during lactation. OBJECTIVE: The purpose of this study was to report the use of preexposure prophylaxis and to identify gaps in HIV prevention services for women who were at substantial risk of HIV preconception and during pregnancy and lactation at 2 United States medical centers...
July 19, 2016: American Journal of Obstetrics and Gynecology
Andres F Camacho-Gonzalez, Miriam C Chernoff, Paige L Williams, Ann Chahroudi, James M Oleske, Shirley Traite, Rana Chakraborty, Murli U Purswani, Mark J Abzug
BACKGROUND: Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), disproportionately affect adolescents and young adults (AYAs) ages 13-24 years. Sexually transmitted infections likewise are a risk factor for HIV acquisition and transmission; however, there is a lack of data on STI acquisition in HIV-infected AYAs. METHODS: We determined the incidence of STIs in HIV-infected AYAs 12.5 <25 years of age in the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1074 observational cohort study...
July 20, 2016: Journal of the Pediatric Infectious Diseases Society
Myriam E Torres, Ashley Murray, Edena G Meetze, Zaneta Gaul, Madeline Y Sutton
To inform and strengthen culturally-tailored HIV perinatal prevention, we assessed HIV knowledge among pregnant Latinas receiving prenatal care in rural South Carolina. We administered an 11 item HIV knowledge scale (n = 171). Women who answered 8 of 11 (73 %) items correctly were categorized as having "high" knowledge; <8 items correct was categorized as "low" knowledge. Seventy-six percent of participants had low HIV knowledge; only 37 % knew that there is medicine to prevent mother-to-child HIV transmission...
July 8, 2016: Journal of Immigrant and Minority Health
Zenita Alidina, Anne E Wormsbecker, Marcelo Urquia, Jay MacGillivray, Evan Taerk, Mark H Yudin, Douglas M Campbell
Background. Perinatal HIV transmission is less than 1% with antiretroviral (ARV) prophylaxis. Transmission risk appears higher in "high risk" dyads, yet this is not well defined, possibly exposing more infants to combination ARV compared with standard care. Objective. To describe characteristics of mother-infant dyads where infants received ARVs and how these characteristics relate to specific ARV regimens. Methods. Retrospective chart review of ARV-receiving newborns at St. Michael's Hospital from 2007 to 2012 (and their mothers)...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Jennifer R Pharr, Michael C Obiefune, Chinenye O Ezeanolue, Alice Osuji, Amaka G Ogidi, Semiu Gbadamosi, Dina Patel, Juliet Iwelunmor, Wei Yang, Gbenga Ogedegbe, John E Ehiri, Nadia A Sam-Agudu, Echezona E Ezeanolue
BACKGROUND: In 2014, Nigeria accounted for 33% of all new childhood HIV infections that occurred among the 22 Global Plan priority countries where 80% of HIV-infected women reside. Even with a vertical HIV transmission rate of 27%, only 6% of infants born to HIV-infected women in Nigeria receive early infant diagnosis (EID). This article reports rates of antiretroviral prophylaxis, EID, and mother-to-child transmission in a congregation-based Healthy Beginning Initiative (HBI) designed to increase HIV testing among pregnant women in southeast Nigeria...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Naomi K Tepper, Kathryn M Curtis, Kavita Nanda, Denise J Jamieson
BACKGROUND: Use of highly effective contraception among women living with HIV is critical to prevent unintended pregnancy and subsequent risk of maternal complications and perinatal HIV transmission. However, it is not known whether use of intrauterine devices (IUDs) among women with advanced HIV disease poses an increased risk of pelvic infection or HIV progression and transmission. OBJECTIVES: To identify evidence regarding the risk of pelvic infection, HIV disease progression or HIV transmission among women with HIV using IUDs, and whether this risk differs by severity of HIV disease...
June 22, 2016: Contraception
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