scholarly journals Fetal-maternal surgery for spina bifida in a HIV-infected mother

2022 ◽  
Author(s):  
Julia Elrod ◽  
Nicole Ochsenbein-Kölble ◽  
Luca Mazzone ◽  
Roland Zimmermann ◽  
Christoph Berger ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Hiv Transmission ◽  
A Priori ◽  
Fetal Surgery ◽  
In Utero ◽  
Exclusion Criterion ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Selection Of ◽  
Hiv Negative

INTRODUCTION: In select cases, in utero surgery for MMC leads to better outcomes than postnatal repair. However, maternal HIV infection constitutes a formal exclusion criterion due to the potential of vertical HIV transmission. Encouraged by a previous case of a successful fetal spina bifida repair in a Hepatitis Bs antigen positive woman, a plan was devised allowing for fetal surgery. CASE REPORT: In utero MMC repair was performed although the mother was HIV-infected. To minimize the risk of in utero HIV transmission, the mother was treated by HAART throughout gestation as well as intravenous zidovudine administration during maternal-fetal surgery. The mother tolerated all procedures very well without any sequelae. The currently 20 month-old toddler, is HIV negative and has significantly benefitted from fetal surgery. DISCUSSION/CONCLUSION: This case shows that maternal HIV is not a priori a diagnosis that excludes fetal surgery. Rather, it might be a surrogate for moving towards personalized medicine and away from applying too rigorous exclusion criteria in the selection of candidates for maternal-fetal surgery.

In utero Hepatitis B Immunization during Fetal Surgery for Spina Bifida

2019 ◽  
Vol 47 (4) ◽  
pp. 328-332 ◽  
Author(s):  
Ueli Moehrlen ◽  
Julia Elrod ◽  
Nicole Ochsenbein-Kölble ◽  
Christoph Berger ◽  
Roberto F. Speck ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Hepatitis B ◽  
Fetal Surgery ◽  
In Utero

scholarly journals Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda

2013 ◽  
Vol 16 (9) ◽  
pp. 1548-1557 ◽  
Author(s):  
Lawrence Muhangi ◽  
Swaib A Lule ◽  
Harriet Mpairwe ◽  
Juliet Ndibazza ◽  
Moses Kizza ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Maternal Education ◽  
Hiv Transmission ◽  
Growth Data ◽  
Poor Growth ◽  
Growth Outcomes ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Exposed ◽  
Living Children

AbstractObjectiveTo assess the associations between maternal HIV infection and growth outcomes of HIV-exposed but uninfected infants and to identify other predictors for poor growth among this population.DesignWithin a trial of de-worming during pregnancy, the cohort of offspring was followed from birth. HIV status of the mothers and their children was investigated and growth data for children were obtained at age 1 year. Length-for-age, weight-for-age and weight-for-length Z-scores were calculated for each child; Z-scores <−2 were defined as stunting, underweight and wasting, respectively.SettingThe study was conducted in Entebbe municipality and Katabi sub-county, Uganda.SubjectsThe sample consisted of 1502 children aged 1 year: HIV-unexposed (n 1380) and HIV-exposed not infected (n 122).ResultsPrevalence of stunting, underweight and wasting was 14·2 %, 8·0 % and 3·9 %, respectively. There was evidence for an association between maternal HIV infection and odds of being underweight (adjusted OR = 2·32; 95 % CI 1·32, 4·09; P = 0·006) but no evidence for an association with stunting or with wasting. Young maternal age, low maternal education, low birth weight, early weaning and experiencing a higher number of episodes of malaria during infancy were independent predictors for stunting and underweight. A higher number of living children in the family was associated with wasting.ConclusionsMaternal HIV infection was associated with being underweight in HIV-exposed uninfected infants. The success of programmes for prevention of mother-to-child HIV transmission means that an increasing number of infants will be born to HIV-infected women without acquiring HIV. Therefore, viable nutritional interventions need to be identified for this population.

scholarly journals in utero HIV exposure and the early nutritional environment influence neurodevelopment in infants before age three: findings from an evidenced review and meta-analysis.

2020 ◽  
Author(s):  
Marina White ◽  
Kristin L Connor
Keyword(s):  
Hiv Infection ◽  
Early Life ◽  
Meta Analysis ◽  
In Utero ◽  
Nutrition Interventions ◽  
Neurodevelopmental Outcomes ◽  
Maternal Hiv ◽  
Nutritional Environment ◽  
Maternal Hiv Infection ◽  
Hiv Exposure

The developing brain is especially vulnerable to infection and suboptimal nutrition during the pre- and early postnatal periods. Exposure to maternal HIV infection and antiretroviral therapies (ART) in utero and during breastfeeding can adversely influence infant (neuro)developmental trajectories. How early life nutrition may be optimised to improve neurodevelopmental outcomes for infants who are HIV/ART-exposed has not been well characterised. We conducted an up-to-date evidence review and meta-analysis on the influence of HIV exposure in utero and during breastfeeding, and early life nutrition, on infant neurodevelopmental outcomes before age three. We report that exposure to maternal HIV infection/ART may adversely influence expressive language development, in particular, and these effects may be detectable within the first three years of life. Further, while male infants may be especially vulnerable to HIV/ART exposure, few studies overall reported sex-comparisons, and whether there are sex-dependent effects of HIV exposure on neurodevelopment remains a critical knowledge gap to fill. Lastly, early life nutrition interventions, including daily maternal multivitamin supplementation during the perinatal period, may improve neurodevelopmental outcomes for infants who are HIV-exposed. Our findings suggest that the early nutritional environment may be leveraged to improve early neurodevelopmental trajectories in infants who have been exposed to HIV in utero. A clear understanding of how this environment should be optimised is key for developing targeted nutrition interventions during critical developmental periods in order to mitigate adverse outcome later in life, and should be a priority of future research.

Meconium aspiration syndrome in infants of HIV-positive women: a case-control study

2016 ◽  
Vol 44 (4) ◽  
Author(s):  
Sachin K. Gupta ◽  
Pam Haerr ◽  
Richard David ◽  
Alok Rastogi ◽  
Suma Pyati
Keyword(s):  
Case Control Study ◽  
Meconium Aspiration Syndrome ◽  
Case Control ◽  
Hiv Positive ◽  
Meconium Aspiration ◽  
Hiv Positive Women ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Control Study ◽  
Hiv Negative

AbstractOur aim was to determine whether maternal HIV infection in the current era is associated with an increased incidence of meconium aspiration syndrome (MAS) in their infants.Infants born to 149 HIV-positive women at our hospital over a 5-year period were compared with infants born to HIV-negative women in a retrospective case-control study. Charts of all 298 patients included in the study were reviewed for maternal and infant demographics, HIV treatment, vertical transmission and untoward events at delivery or during the hospital course.When compared with HIV-negative women, a greater proportion of HIV-positive women had meconium-stained amniotic fluid (MSAF), 33% vs. 13%, P<0.001; and thick MSAF, 17% vs. 5%, P<0.001, respectively. Seven of 298 infants were admitted to the neonatal intensive care unit for MAS; all seven were born to HIV-positive women (P=0.015). AlthoughInfants born to HIV-positive women had significantly more MSAF and MAS than infants born to non-infected women. It is unclear whether this association results from maternal HIV infection itself or from anti-retroviral therapy. Maternal and infant care providers should be prepared for this complication when attending to the deliveries of HIV-positive women.

scholarly journals In-utero exposure to maternal HIV infection alters T-cell immune responses to vaccination in HIV-uninfected infants

AIDS ◽  
2014 ◽  
Vol 28 (10) ◽  
pp. 1421-1430 ◽  
Author(s):  
Elvis B. Kidzeru ◽  
Anneke C. Hesseling ◽  
Jo-Ann S. Passmore ◽  
Landon Myer ◽  
Hoyam Gamieldien ◽  
...  
Keyword(s):  
T Cell ◽  
Immune Responses ◽  
Hiv Infection ◽  
In Utero ◽  
In Utero Exposure ◽  
Maternal Hiv ◽  
T Cell Immune Responses ◽  
Maternal Hiv Infection

scholarly journals How do maternal HIV infection and the early nutritional environment influence the development of infants exposed to HIV in utero?

2019 ◽  
Author(s):  
Marina White ◽  
Eleanor Duffley ◽  
Ute D. Feucht ◽  
Theresa Rossouw ◽  
Kristin L. Connor
Keyword(s):  
Hiv Infection ◽  
Food Insecurity ◽  
Infant Development ◽  
Dietary Diversity ◽  
In Utero ◽  
Nutrient Intakes ◽  
Increased Risk ◽  
Maternal Hiv ◽  
Nutritional Environment ◽  
Maternal Hiv Infection

AbstractMalnutrition and infectious disease often coexist in socially inequitable contexts. Malnutrition in the perinatal period adversely affects offspring development and lifelong non-communicable disease risk. Less is known about the effects of infectious disease exposure during critical windows of development and health, and links between in utero HIV-exposure in the absence of neonatal infection, perinatal nutritional environments, and infant development are poorly defined. In a pilot feasibility study at Kalafong Hospital, Pretoria, South Africa, we aimed to better understand relationships between maternal HIV infection and the early nutritional environment of in utero HIV exposed uninfected (HEU) infants. We also undertook exploratory analyses to investigate relationships between food insecurity and infant development. Mother-infant dyads were recruited after delivery and followed until 12 weeks postpartum. Household food insecurity, nutrient intakes and dietary diversity scores did not differ between mothers living with or without HIV. Maternal reports of food insecurity were associated with lower maternal nutrient intakes 12 weeks postpartum, and in infants, higher brain-to-body weight ratio at birth and 12 weeks of age, and attainment of fewer large movement and play activities milestones at 12 weeks of age, irrespective of maternal HIV status. Reports of worry about food runout were associated with increased risk of stunting for HEU, but not unexposed, uninfected infants. Our findings suggest that food insecurity, in a vulnerable population, adversely affects maternal nutritional status and infant development. In utero exposure to HIV may further perpetuate these effects, which has implications for early child development and lifelong human capital.

scholarly journals Maternal HIV infection is associated with distinct systemic cytokine profiles throughout pregnancy in South African women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charlene Akoto ◽  
Shane A. Norris ◽  
Joris Hemelaar
Keyword(s):  
Hiv Infection ◽  
First Trimester ◽  
African Women ◽  
Cytokine Profiles ◽  
Women Living With Hiv ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Adverse Pregnancy ◽  
South African Women ◽  
Hiv Negative

AbstractMaternal HIV infection is associated with adverse pregnancy outcomes, but the mechanisms remain unknown. The course of pregnancy is regulated by immunological processes and HIV infection and antiretroviral therapy (ART) impact key immune mechanisms, which may disrupt the immune programme of pregnancy. We evaluated a broad range of systemic cytokines at each trimester of pregnancy in 56 women living with HIV (WLHIV) and 68 HIV-negative women, who were enrolled in a prospective pregnancy cohort study in Soweto, South Africa. The pro-inflammatory cytokine IP-10 was detected in each trimester in all WLHIV, which was significantly more than in HIV-negative women. The anti-viral cytokine IFNλ1 was detected more frequently in WLHIV, whereas IFNβ and IFNλ2/3 were detected more frequently in HIV-negative women. Th1 cytokines IL-12 and IL-12p70, Th2 cytokine IL-5, and Th17 cytokine IL-17A were detected more frequently in WLHIV throughout pregnancy. Il-6, IL-9, and IL-10 were more commonly detected in WLHIV in the first trimester. Trends of increased detection of Th1 (IL-2, IL-12p70), Th2 (IL-4, Il-5, Il-13) and Th17 (IL-17A, Il-17F, IL-21, IL-22) cytokines were associated with small-for-gestational-age babies. Our findings indicate that maternal HIV/ART is associated with distinct systemic cytokine profiles throughout pregnancy.

RISK FOR PERINATAL HIV-1 TRANSMISSION ACCORDING TO MATERNAL IMMUNOLOGIC, VIROLOGIC, AND PLACENTAL FACTORS

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 275-276
Author(s):  
Joseph Church
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Perinatal Hiv ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
The Impact ◽  
Hiv 1

Subgroups of HIV-infected women based upon maternal immunologic and placental characteristics had a risk of perinatal HIV transmission that varied from 7% to 71%. The impact of different risk factors for perinatal HIV vary over the course of maternal HIV infection.

Innovative Approach to Information Search by Example of a Patent Analysis of an Important Substitution Plan

2020 ◽  
pp. 143-157
Author(s):  
Maria A. Milkova
Keyword(s):  
Information Search ◽  
Topic Modeling ◽  
Cognitive Biases ◽  
A Priori ◽  
Import Substitution ◽  
Innovative Approach ◽  
Iterative Search ◽  
Comprehensive Picture ◽  
Priori Information ◽  
Selection Of

Nowadays the process of information accumulation is so rapid that the concept of the usual iterative search requires revision. Being in the world of oversaturated information in order to comprehensively cover and analyze the problem under study, it is necessary to make high demands on the search methods. An innovative approach to search should flexibly take into account the large amount of already accumulated knowledge and a priori requirements for results. The results, in turn, should immediately provide a roadmap of the direction being studied with the possibility of as much detail as possible. The approach to search based on topic modeling, the so-called topic search, allows you to take into account all these requirements and thereby streamline the nature of working with information, increase the efficiency of knowledge production, avoid cognitive biases in the perception of information, which is important both on micro and macro level. In order to demonstrate an example of applying topic search, the article considers the task of analyzing an import substitution program based on patent data. The program includes plans for 22 industries and contains more than 1,500 products and technologies for the proposed import substitution. The use of patent search based on topic modeling allows to search immediately by the blocks of a priori information – terms of industrial plans for import substitution and at the output get a selection of relevant documents for each of the industries. This approach allows not only to provide a comprehensive picture of the effectiveness of the program as a whole, but also to visually obtain more detailed information about which groups of products and technologies have been patented.

Sign in / Sign up

Export Citation Format

Share Document