Maternal HIV Infection and Vertical Transmission of Pathogenic Bacteria

Background: The effect of HIV on obstetric complications is known to vary across regions of world. The variation may be due to HIV infection per se or it may be due to complex interaction of related medical and social conditions that affect pregnancy. Incidence of these obstetric complications in HIV infected pregnant women is not well reported in India. So, this prospective cohort study was carried to observe the demographics and incidence of obstetrics complications like abortions, still birth, premature rupture of membranes, preterm delivery, opportunistic infections in HIV infected pregnant women.Methods: All pregnant women who were screened positive for HIV test, irrespective of their gestational age were included in the study. Apart from routine obstetric care, CD4 cell count was carried out. The patients were followed up till term, delivery and up to 6-week postpartum period. Obstetric outcomes like incidence of abortion, intrauterine death, preterm delivery and premature rupture of membrane were noted. Baby`s birth weight and the incidence of maternal opportunistic infection were noted and correlated with maternal CD4 cell count.Results: Maternal HIV infection is associated pre-term labour in 34.5%, PROM in 30%, low birth weight in 52.3%. Increased incidences of these adverse outcomes have an inverse relationship with CD4 count.Conclusions: Maternal HIV infection is associated with increased incidence of adverse obstetric outcome and opportunistic infection, and their incidences increase with lower CD4 count.

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Causal Effect of Maternal HIV on Child Health Outcomes in the Context of Prevention of Mother to Child HIV Transmission (PMTCT) in Malawi

10.21203/rs.2.15528/v1 ◽

2019 ◽

Author(s):

Halima Sumayya Twabi ◽

Samuel O Manda ◽

Dylan S Small

Keyword(s):

Birth Weight ◽

Propensity Score ◽

Hiv Infection ◽

Exclusive Breastfeeding ◽

Causal Effect ◽

Mediating Effect ◽

Pmtct Program ◽

Hiv Status ◽

Maternal Hiv ◽

Maternal Hiv Infection

Abstract Evidence has shown that maternal HIV infection has adverse effects on child birth weight. However, the effect of anti-retroviral therapy (ART) on pregnancy outcome is not conclusive. Ascertaining causality of these associations remain largely unexamined and untested, and if confirmed would help policy makers to improve implementation and sensitization of PMTCT program. However, assessing causal effect has been limited due to ethical concerns if randomized controlled trials are appropriate. We aim to estimate the causal effect of maternal HIV on birth weight and the causal effect of knowledge of HIV status on exclusive breastfeeding while ascertaining the mediating effect of ART using observational data. Data on over 18,000 and 16,000 children still alive and born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys were analysed. A set of methods for confounder balance namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting the propensity score (PS) were used. Before matching, place of residence, region, anaemia level and age were statistically different between HIV-infected and HIV-uninfected mothers for both the 2010 and 2015-16 data. After matching, the selected confounding variables were distributed similarly between HIV-infection statuses. Maternal HIV infection had a negative effect on infant birth weight for the 2010 data and had a positive effect on birth weight for the 2015-16 data with p-values <0.001. Uptake of ART did not mediate the effect of HIV infection on birth weight. Maternal knowledge of HIV status was not associated with behaviour concerning exclusive breastfeeding. We have found conflicting evidence on the association between maternal HIV infection and birth weight. The adverse association between maternal HIV infection and child birth weight found for the 2010 data could more likely be causal. However, the increased birth weight among infants born to HIV infected mothers in 2015-16 may show the recent successes of policies and interventions within the PMTCT program in Malawi. However, the purported mediating effect of ART on the association between HIV infection and birth weight was not found. Prenatal care interventions should continue to be supported among ANC clinics in Malawi.

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Impact of maternal HIV infection on obstetrical and early neonatal outcome

AIDS ◽

10.1097/00002030-199010000-00009 ◽

1990 ◽

Vol 4 (10) ◽

pp. 1001-1006 ◽

Cited By ~ 77

Author(s):

Michael R. Braddick ◽

Joan K. Kreiss ◽

Joanne E. Embree ◽

Pratibha Datta ◽

Jack O. Ndinya-Achola ◽

...

Keyword(s):

Hiv Infection ◽

Neonatal Outcome ◽

Maternal Hiv ◽

Maternal Hiv Infection

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Localization of Human Immunodeficiency Virus Core Antigen in Term Human Placentas

PEDIATRICS ◽

10.1542/peds.89.2.207 ◽

1992 ◽

Vol 89 (2) ◽

pp. 207-209

Author(s):

Carl F. T. Mattern ◽

Karen Murray ◽

Allison Jensen ◽

Homayoon Farzadegan ◽

Jenny Pang ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Mononuclear Cells ◽

Morphological Characteristics ◽

Core Antigen ◽

Hiv Replication ◽

Immunodeficiency Virus ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Hiv Seropositive

Evidence of human immunodeficiency virus (HIV) replication was sought in human placentas obtained at term from pregnancies complicated by maternal HIV infection. Placentas were obtained from the pregnancies of 19 HIV-seropositive women, 4 women who were seronegative, and 4 untested women with no risk factors for HIV infection. These placentas were each examined by immunoperoxidase immunocytochemistry using monoclonal anti-p24/55 antibodies. In addition, minced placental tissue from 11 of the seropositive pregnancies and the 3 seronegative pregnancies were co-cultivated with stimulated human peripheral blood mononuclear cells. The clinical status of the infants born to the HIV-seropositive women was assessed when the infants were 8 to 28 months of age. P24/55 antigen was detected in 5 of the 19 placentas of the HIV-seropositive pregnancies and in none of the 8 placentas of seronegative or low-risk pregnancies. This HIV core viral antigen was located exclusively in the cytoplasm of villous cells with morphological characteristics of macrophages. The HIV antigen-containing cells were very sparsely distributed. Staining of the trophoblast was not observed in any placental specimen. Human immunodeficiency virus was isolated in culture from 3 of the 11 placentas from seropositive pregnancies. Clinical follow-up has not revealed a relationship between infection of the infant and either p24/55 antigen identification or isolation of virus from the placenta. Virological and histological evidence of HIV replication is found in approximately one fourth of placentas obtained at term from pregnancies complicated by maternal HIV infection. Replicating virus appears localized to sparse macrophages located within the chorionic villi, but specifically not within the trophoblastic layer. It is unlikely that identification of HIV in the placenta either by culture or by immunocytochemistry will predict infection of infants born to seropositive women.

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