Antiretroviral Therapy in Pregnant Women

2017 ◽  
Author(s):  
William R. Short ◽  
Jason J. Schafer
Keyword(s):  
Pregnant Women ◽  
Antiretroviral Drugs ◽  
Virologic Suppression ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Virologic Control ◽  
Treatment Changes ◽  
Mother To Child ◽  
Hiv 1 ◽  
Pregnancy Registry

Research has demonstrated that proper prevention strategies and interventions during pregnancy, labor, and delivery can significantly reduce the rate of mother-to-child transmission of HIV. Antiretroviral drugs (ARVs) should be initiated in all HIV-infected pregnant women regardless of CD4+ T cell count or HIV-1 RNA level. ARVs should be given in combination therapy, similar to nonpregnant patients, with the goal of complete virologic suppression. Treatment changes during pregnancy have been associated with the loss of virologic control and independently associated with mother-to-child transmission. All cases of prenatal antiretroviral exposure should be reported to the Antiretroviral Pregnancy Registry, which collects data on HIV-infected pregnant women taking ARVs with the goal of detecting any major teratogenic effects.

Incident and long-term HIV-1 infection among pregnant women in Brazil: Transmitted drug resistance and mother-to-child transmission

2016 ◽  
Vol 88 (11) ◽  
pp. 1936-1943 ◽  
Author(s):  
Yanna Andressa Ramos Lima ◽  
Ludimila Paula Vaz Cardoso ◽  
Mônica Nogueira da Guarda Reis ◽  
Mariane Martins Araújo Stefani
Keyword(s):  
Drug Resistance ◽  
Pregnant Women ◽  
Transmitted Drug Resistance ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child ◽  
Hiv 1

scholarly journals Influence of human immunodeficiency virus type 1 subtype on mother-to-child transmission

2003 ◽  
Vol 84 (3) ◽  
pp. 607-613 ◽  
Author(s):  
Natàlia Tàpia ◽  
Sandra Franco ◽  
Francesc Puig-Basagoiti ◽  
Clara Menéndez ◽  
Pedro Luis Alonso ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Pregnant Women ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Immunodeficiency Virus ◽  
Mother To Child ◽  
Hiv 1

The present study was designed to assess whether the subtype of human immunodeficiency virus type 1 (HIV-1) could affect the rate of HIV-1 mother-to-child transmission in a cohort of 31 HIV-1-seropositive pregnant Tanzanian women. In order to assign a subtype to the samples analysed, nucleotide sequencing of the HIV-1 long terminal repeat U3 and C2V3C3 envelope regions was performed from the sera of these 31 pregnant women. Except in three cases, amplification of both regions was achieved in all samples. Subtypes A (n=13, 46 %), C (n=6, 21 %) and D (n=2, 7 %), as well as a number (25 %) of A/C, C/A, D/A and C/D recombinant forms (n=3, 2, 1 and 1, respectively), were identified. Of the 31 HIV-1 seropositive pregnant women analysed, eight (26 %) transmitted HIV-1 to their infants. Among the eight transmitter mothers, four (4 of 13, 31 %) were infected with HIV-1 subtype A, one (1 of 6, 17 %) with HIV-1 subtype C, none (0 of 2, 0 %) with HIV-1 subtype D and three (3 of 7, 43 %) with HIV-1 subtype recombinant A/C. These findings show no significant differences in the mother-to-child transmissibility of HIV-1 subtypes A, C and D and detected recombinants forms.

scholarly journals Monitoring of HIV pregnant women for evaluating mother-to-child transmission in Sao Paulo, 2010-2018

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S B Domingues ◽  
M Fonsi ◽  
M V Tancredi ◽  
A P Loch ◽  
S Q Rocha ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sao Paulo ◽  
Antiretroviral Drugs ◽  
Clinical Monitoring ◽  
São Paulo ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Antiretroviral Drug ◽  
Aids Program ◽  
Mother To Child

Abstract Issue In the state of São Paulo (SSP), the rate of mother-to-child transmission of HIV (MTCT) was estimated at 2.7%, in 2006. However, for reaching elimination, its level should be < 2%. From 2000 to 2018, the SSP concentrated 21.3% (26,427/125,144) of the total cases of pregnant women living with HIV (PWLH) in Brazil. Description of the Problem The occurrence of MTCT cases shows failures of healthcare system. The aim of this study was to assess the response of the Sao Paulo State STI/AIDS Program to prevent MTCT, from 2010 to 2018. A descriptive analysis of clinical monitoring indicators of the PWLH was performed. The National Surveillance Data System was used to estimate the underreporting of cases. Data from antiretroviral drug delivery, viral load (VL) and genotyping results were used to calculate the indicators and were obtained through database of the National Antiretroviral Drug System, Laboratory Control System and Genotyping System. Results In the period, despite identifying 15,463 PWLH in the systems, only 11,316 were notified (26.8% underreporting). Comparing 2010 and 2018, there was an improvement in accessing combined antiretroviral therapy (cART) from 81.2% (1,366/1,683) to 86.6% (1,543/1,782); in performing of VL before delivery from 70.8% (1.192/1.683) to 72.8% (1.298/1.782); in VL suppression <50 copies/mL from 39.9% (671/1,683) to 53.4% (951/1,782); and in the pretreatment genotyping from 0.2% (2/992) to 22.4% (154/688). In 2016, the loss of follow up of cART in 6 and 18 months after delivery was 20% and 24%, respectively. Additionally, the number of children born with HIV decreased 79.7%, from 64 to 13 cases. Lessons The decrease in the number of cases suggests improvement in preventing MTCT in the SSP. However, many challenges remain, such as breaking down individual, social and programmatic barriers to expand access to cART, pretreatment genotyping, VL suppression before delivery, retention in care and adherence to cART over time. Key messages The National Systems of surveillance, antiretroviral drugs, laboratory and genotyping network are important for performing clinical monitoring, reducing treatment gaps and underreporting. The integration of the Sexually Transmitted Infections and HIV/AIDS Program with the Primary Care and the Maternal and Child Health Program is essential to achieve the goals of eliminating MTCT.

scholarly journals Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Stephane Tshitenge ◽  
Andre Citeya ◽  
Adewale Ganiyu
Keyword(s):  
Pregnant Women ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
District Health ◽  
Retrospective Audit ◽  
Hiv Exposed ◽  
Mother To Child

Background: The Mahalapye district health management team (DHMT) conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT) programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme.Aim: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines.Setting: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana.Methods: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013.Results: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19%) knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69%) were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67%) took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89%) were HIV DNA PCR negative at 6 weeks. Thirty-two (73%) children were given cotrimoxazole prophylaxis between 6 and 8 weeks.Conclusion: The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.

scholarly journals HIV-1 mother-to-child transmission and drug resistance among Brazilian pregnant women with high access to diagnosis and prophylactic measures

2012 ◽  
Vol 54 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Keila Correia Alcântara ◽  
Janaína Bacelar Accioli Lins ◽  
Maly Albuquerque ◽  
Letícia Mara Aires ◽  
Ludimila Paula Vaz Cardoso ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pregnant Women ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Prophylactic Measures ◽  
Mother To Child ◽  
Hiv 1

scholarly journals Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria

2006 ◽  
Vol 48 (2) ◽  
pp. 77-80 ◽  
Author(s):  
G.N. Odaibo ◽  
D.O. Olaleye ◽  
L. Heyndrickx ◽  
K. Vereecken ◽  
K. Houwer ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Mononuclear Cells ◽  
Transmission Rate ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Peripheral Blood Mononuclear ◽  
Informed Consent Form ◽  
Mother To Child ◽  
Hiv 1

The rate of mother-to-child transmission (MTCT) of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs) were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg), G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.

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