74: Rupture of membranes greater than four hours is not a risk factor for perinatal HIV transmission in the era of combination antiretroviral therapy

2011 ◽  
Vol 204 (1) ◽  
pp. S42-S43 ◽  
Author(s):  
Kathleen Brookfield ◽  
Lunthita Duthely ◽  
Amanda Cotter
Keyword(s):  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Combination Antiretroviral Therapy ◽  
Perinatal Hiv

scholarly journals Is ventricular arrhythmias the end for all conditions ?

2021 ◽  
Author(s):  
Ahmet Goktug Ertem ◽  
Mehmet Akif Erdol ◽  
Koray Demirtas ◽  
Sefa Unal ◽  
Mustafa Karanfil ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Ventricular Arrhythmias ◽  
Combination Antiretroviral Therapy ◽  
T Wave ◽  
Medical Status ◽  
Immunodeficiency Virus ◽  
Duration Of Disease ◽  
Severity Of The Disease

Dear Editor, We read the article entitled “Abnormal Dispersion of Ventricular Repolarization as a Risk Factor in Patients with Human Immunodeficiency Virus: Tp-e Interval, Tp-e/QTc Ratio” by Unal Evren et al. with interest[1]. The authors evaluated the changes in Tp-e interval, Tp-e/QT and Tp-e/corrected QT (QTc) ratios, and traditional electrocardiographic features of electrical dispersion in adults infected with Human Immunodeficiency Virus (HIV) and their study revealed that the cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were prolonged and correlated to the severity of the disease in HIV-infected patients. Previous studies have revealed that the Tp–e interval, the Tpeak-Tend interval (Tpe), the interval from the T-wave peak to the end of the T wave, has been related to arrhythmogenesis, is specified as an index of totaldispersion of repolarization[2]. Prolonged Tp–e interval is predictable for ventricular arrhythmias and mortality [3]. Unal et al. showed that HIV-infected patients receiving combination antiretroviral therapy (cART) were associated withlonger Tp–e interval and Tp–e/QTc ratio and correlated positively with the duration of disease and the electrophysiologicalabnormalities, and negatively with CD4 count[4]. There were no informations about medical status of patients with HIV, duration of the disease and why hsCRP is higher in patients’ group. The patients were in active phases of infection. We think that these are important datas for results of the study. We thank the authors for adding this article to the literature

scholarly journals Maternal Lopinavir/Ritonavir Is Associated with Fewer Adverse Events in Infants than Nelfinavir or Atazanavir

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Christiana Smith ◽  
Adriana Weinberg ◽  
Jeri E. Forster ◽  
Myron J. Levin ◽  
Jill Davies ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hiv Transmission ◽  
Illicit Drug ◽  
Combination Antiretroviral Therapy ◽  
Liver Enzyme Elevation ◽  
Perinatal Hiv ◽  
Confounding Variables ◽  
Race Ethnicity ◽  
Grade 3 ◽  
Enzyme Elevation

Combination antiretroviral therapy (cART) is successfully used for prevention of perinatal HIV transmission. To investigate safety, we compared adverse events (AE) among infants exposed to different maternal cART regimens. We reviewed 158 HIV-uninfected infants born between 1997 and 2009, using logistic regression to model grade ≥1 AE and grade ≥3 AE as a function of maternal cART and confounding variables (preterm, C-section, illicit drug use, race, ethnicity, infant antiretrovirals, and maternal viremia). Frequently used cART regimens included zidovudine (63%), lamivudine (80%), ritonavir-boosted lopinavir (37%), nelfinavir (26%), and atazanavir (10%). At birth, anemia occurred in 13/140 infants (9%), neutropenia in 27/107 (25%), thrombocytopenia in 5/133 (4%), and liver enzyme elevation in 21/130 (16%). Corresponding rates of AE at 4 weeks were 59/141 (42%), 54/130 (42%), 3/137 (2%), and 3/104 (3%), respectively. Serious AE (grade ≥ 3) exceeded 2% only for neutropenia (13% at birth; 9% at 4 weeks). Compared with infants exposed to maternal lopinavir/ritonavir, infants exposed to nelfinavir and atazanavir had a 5-fold and 4-fold higher incidence of AE at birth, respectively. In conclusion, hematologic and hepatic AE were frequent, but rarely serious. In this predominantly protease inhibitor-treated population, lopinavir/ritonavir was associated with the lowest rate of infant AE.

scholarly journals Perinatal HIV Transmission Prevention: Challenges among Women Living with HIV in sub-Saharan Africa

2020 ◽  
Vol 9 (3) ◽  
pp. 354-359
Author(s):  
Elizabeth Armstrong-Mensah ◽  
Krystal Ruiz ◽  
Aminata Fofana ◽  
Victoria Hawley
Keyword(s):  
Antiretroviral Therapy ◽  
Sex Education ◽  
Hiv Transmission ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Creative Commons ◽  
Perinatal Hiv ◽  
Transmission Prevention ◽  
Sub Saharan ◽  
Hiv Transmission Prevention

About 86 percent of the estimated 160,000 children newly-infected with the human immunodeficiency virus (HIV) live in sub-Saharan Africa. Despite global efforts to reduce perinatal HIV transmission, this phenomenon continues to be a public health problem in sub-Saharan Africa. This paper discusses challenges associated with perinatal HIV transmission prevention in sub-Saharan Africa and offers strategies for the way forward. These strategies include safe sex education and behavioral change, increased access to integrated antenatal care, training of unskilled traditional birth attendants into formal delivery systems, access to antiretroviral therapy, and investing in virologic testing. Key words: • HIV • Perinatal • Antiretroviral Therapy • Mother to Child HIV Transmission • HIV Prevention • Sub-Saharan Africa   Copyright © 2020 Armstrong-Mensah, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Adherence to Combination Antiretroviral Therapy among Pregnant Women Enrolled in a HIV Prevention Program in Rural North-central Nigeria

2020 ◽  
Vol 9 (1) ◽  
pp. 81-92
Author(s):  
Cedrina L. Calder ◽  
Heather O ◽  
Mohammad Tabatabai ◽  
Celia J. Maxwell ◽  
Salisha Marryshow ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Secondary Analysis ◽  
Self Report ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
North Central ◽  
Hiv Positive Women ◽  
Mother To Child

Objective: Adherence to combination antiretroviral therapy (ART) among pregnant women is essential to attaining the goal of eliminating mother-to-child HIV transmission. The objective of this study was to determine which factors affect adherence to ART among HIV-positive women enrolled in a large prevention of mother-to-child HIV transmission (PMTCT) trial in rural north-central Nigeria. Methods: The parent study included 372 HIV-positive pregnant women enrolled in a cluster-randomized control trial conducted at 12 health facilities in Nigeria between 2013 and 2015. This secondary analysis included HIV-positive women (and their infants) from the original trial with documented adherence data (n=210, 56.5%). The primary outcome was maternal adherence to ART, determined by self-report and based on the visual analogue scale (VAS) of a validated medication adherence tool. Participants with a VAS score of ? 95% were classified as adherent. We employed multivariate logistic regression to evaluate the predictors of maternal ART adherence in the study sample. Results: Approximately 61.0% of study participants (128/210) were adherent to ART. The majority of adherent participants (62.5%, 80/128) were enrolled in the trial intervention arm. The most common cited response for non-adherence was fear of status disclosure. Adherence to ART was associated with study arm (intervention arm vs. control arm, adjusted Odds Ratio (aOR) [95% CI]: 16.95 [5.30-54.23]), maternal ethnicity (Gwari vs. Other, aOR = 0.13 [0.05-0.38]), and partner HIV status (HIV-positive vs. unknown, aOR = 3.14 [1.22-8.07]). Conclusion and Global Health Implications: Adherence to ART among a cohort of pregnant women enrolled in a PMTCT trial in rural North-Central Nigeria was associated with trial arm, maternal self- reported ethnicity, and partner

scholarly journals No association between early antiretroviral therapy during pregnancy and plasma levels of angiogenic factors: a cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ameyo Djeha ◽  
Sylvie Girard ◽  
Helen Trottier ◽  
Fatima Kakkar ◽  
Hugo Soudeyns ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Smoking Status ◽  
Biological Data ◽  
Angiogenic Factors ◽  
Angiogenic Factor ◽  
Premature Delivery ◽  
Second Trimester ◽  
Art Initiation ◽  
Perinatal Hiv

Abstract Background Early antiretroviral therapy (ART) during pregnancy has dramatically reduced the risk of perinatal HIV transmission. However, studies have shown an association between premature delivery and the use of ART during pregnancy (particularly protease inhibitor (PI)-based therapies), which could be explained by placental dysfunction. The objective of this study was to evaluate the association of ART (class, duration of exposure and time of initiation) with placental function by using angiogenic factors placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) as biomarkers. Methods Clinical and biological data from 159 pregnant women living with HIV were analyzed. Levels of each biomarker were measured in the first and second trimester of pregnancy. After logarithmic transformation, we compared these using generalized estimating equations according to (a) the type of ART; (b) the duration of exposure to ART; and (c) the time of initiation of ART. Results After adjusting for variables such as ethnicity, maternal age, gestational age, body mass index, parity, smoking status, and sex of the fetus, we found no significant association between the class of ART (PI-based or not) and serum concentrations of PlGF or sFlt-1. Furthermore, no significant association was found between biomarker levels and the duration of ART exposure or the timing of ART initiation (pre- or post-conception). Conclusions This study suggests that first and second trimester angiogenic factor levels are not significantly associated with ART, regardless of the duration or type (with or without PI). These observations seem reassuring when considering the use of ART during early pregnancy.

scholarly journals No association between early antiretroviral therapy during pregnancy and plasma levels of angiogenic factors: a cohort study

2019 ◽  
Author(s):  
Ameyo Djeha ◽  
Sylvie Girard ◽  
Helen Trottier ◽  
Fatima Kakkar ◽  
Hugo Soudeyns ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Smoking Status ◽  
Biological Data ◽  
Angiogenic Factors ◽  
Angiogenic Factor ◽  
Premature Delivery ◽  
Second Trimester ◽  
Art Initiation ◽  
Perinatal Hiv

Abstract Background: Early antiretroviral therapy (ART) during pregnancy has dramatically reduced the risk of perinatal HIV transmission. However, studies have shown an association between premature delivery and the use of ART during pregnancy (particularly protease inhibitor (PI)-based therapies), which could be explained by placental dysfunction. The objective of this study was to evaluate the association of ART (class, duration of exposure and time of initiation) with placental function by using angiogenic factors placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) as biomarkers. Methods: Clinical and biological data from 159 pregnant women living with HIV were analyzed. Levels of each biomarker were measured in the first and second trimester of pregnancy. After logarithmic transformation, we compared these using generalized estimating equations according to (a) the type of ART; (b) the duration of exposure to ART; and (c) the time of initiation of ART. Results: After adjusting for variables such as ethnicity, maternal age, gestational age, body mass index, parity, smoking status, and sex of the fetus, we found no significant association between the class of ART (PI-based or not) and serum concentrations of PlGF or sFlt-1. Furthermore, no significant association was found between biomarker levels and the duration of ART exposure or the timing of ART initiation (pre- or post-conception). Conclusions: This study suggests that first and second trimester angiogenic factor levels are not significantly associated with ART, regardless of the duration or type (with or without PI). These observations seem reassuring when considering the use of ART during early pregnancy.

Epidemiology and microbiology of subclinical mastitis among HIV-infected women in Malawi

2005 ◽  
Vol 16 (3) ◽  
pp. 227-232 ◽  
Author(s):  
V Nussenblatt ◽  
V Lema ◽  
N Kumwenda ◽  
R Broadhead ◽  
M C Neville ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Breast Milk ◽  
Significant Relationship ◽  
Hiv Transmission ◽  
Subclinical Mastitis ◽  
Maternal Plasma ◽  
Perinatal Hiv ◽  
Leukocyte Counts

The epidemiology and microbiology of subclinical mastitis, a risk factor for perinatal HIV transmission, have not been well characterized. In all, 250 HIV-infected women were followed from two weeks to 12 months postpartum in Blantyre, Malawi, and subclinical mastitis was assessed by breast milk leukocyte counts. The point prevalence of subclinical mastitis at 2, 4, 6, 10, and 14 weeks, and 6, 9, and 12 months was 12.2%, 7.8%, 6.8%, 3.7%, 10.6%, 5.1%, 4.9%, and 1.9%, respectively ( P = 0.002), and 27.2% of women had at least one episode of subclinical mastitis. There was no significant relationship between maternal plasma HIV load or parity and subclinical mastitis. Staphylococcus aureus was isolated in 30% of women with subclinical mastitis, and the proportion of women with positive cultures decreased during follow-up ( P = 0.02). Subclinical mastitis is prevalent among breastfeeding mothers and further studies are needed to characterize the differences between infectious and non-infectious subclinical mastitis.

Mother to child human immunodeficiency virus (HIV) transmission: what HIV-infected women think. Our experience in Rome, Italy

2002 ◽  
Vol 13 (8) ◽  
pp. 551-553
Author(s):  
E Visconti ◽  
Lucia Pastore Celentano ◽  
Salvatore Marinaci ◽  
Giancarlo Scoppettuolo ◽  
Enrica Tamburrini
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Childbearing Age ◽  
Highly Active ◽  
Perinatal Hiv ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Risk Rate ◽  
Mother To Child

Objectives: To investigate the knowledge of the risk of HIV vertical transmission as well as the feeling about the new therapy in reducing that rate. Methods: We included 152 HIV-infected women. A self reported questionnaire was administered from September to December 2000. Results: About the risk rate of transmitting HIV to their baby, 21 (13.8%) women indicated 100%; 67 (44.1%) 50-80%; 35 (23%) 10-50% and only 22 women (14.5%) answered the correct value of less than 5%. Regarding the effect of highly active antiretroviral therapy, 82 women (53.9%) considered therapy effective in reducing vertical HIV transmission, while 63 women (41.4%) considered therapy powerless in preventing mother to child HIV transmission. Any statistically significant difference in sociodemographic, clinical, viroimmunological characteristics and antiretroviral therapy emerged between the groups. Conclusions: Our data highlight the importance of providing appropriate counselling about perinatal HIV transmission to all childbearing age HIV infected women.

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