Letter To The Editor

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 932-932
Author(s):  
Steve Kohl
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Infectious Diseases ◽  
Pregnant Women ◽  
Immunosuppressive Therapy ◽  
Varicella Vaccine ◽  
Hiv Positive ◽  
Letter To The Editor ◽  
Current Vaccine

Dr May's letter raises the important question of the use of varicella vaccine in households with high-risk hosts such as neonates of varicella-susceptible mothers, varicella-susceptible pregnant women, HIV-positive individuals, or individuals receiving immunosuppressive therapy. The manufacturer warns that vaccine recipients avoid such hosts. On the basis of low to absent levels of transmission of vaccine from healthy recipients to others, the Committee on Infectious Diseases feels this is a very unlikely occurrence. In the Weibel study, using a vaccine with ten times the current vaccine viral load, there were no symptomatic transmissions to unvaccinated siblings, and only 3/439 seroconversions attributed to vaccine transmission (although these actually may have been attributed to wild virus).1

Varicella Vaccine and Susceptible Pregnant Mothers

PEDIATRICS ◽  
1996 ◽  
Vol 97 (3) ◽  
pp. 441-441
Author(s):  
BRIAN D. KAN ◽  
MARK J. AULT ◽  
JEFFREY S. GREENSPOON
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
American Academy ◽  
Pregnant Women ◽  
Close Association ◽  
Varicella Vaccine ◽  
Pregnant Mother ◽  
Excellent Review ◽  
American Academy Of Pediatrics ◽  
Pregnant Mothers

Although the American Academy of Pediatrics Committee on Infectious Diseases presented an excellent review on the use of varicella vaccine in children, we are concerned about their recommendation to give the vaccine to children of pregnant women. The Committee recommends, "A pregnant mother or other household member is not a contraindication for vaccination of the child." In contrast, the manufacturer gives the following precaution: "Vaccine recipients should avoid close association with susceptible high-risk individuals (eg, newborns, pregnant women, and immunocompromised persons."

Letter To The Editor

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 932-932
Author(s):  
Duane L. May
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Health Maintenance Organization ◽  
Family Members ◽  
Passive Immunity ◽  
Hiv Positive ◽  
Health Maintenance ◽  
Letter To The Editor ◽  
The Family

The manufacturers of the Varivax vaccine include a warning which states that Varivax recipients should also avoid contact with susceptible high-risk individuals (newborns, pregnant women, immunocompromised persons). In contrast, our health maintenance organization recommends that family members of HIV-positive individuals should receive the Varivax vaccine with the obvious intent of preventing chickenpox within the family complex. I would appreciate your comment as to the risk of immunizing a sibling when there is a newborn within the family complex, particularly if the mother of that newborn had chickenpox as a child, meaning the newborn would have passive immunity to chickenpox for a number of months.

scholarly journals Socio-Demographic Factors and Epidemiological Characteristics of HIV-Positive Pregnant Women with High Risk of Vertical Transmission of the Immunodeficiency Virus

2021 ◽  
Vol 11 (4) ◽  
pp. 564-569
Author(s):  
Anastasiya Vanyarkina ◽  
Alla Petrova ◽  
Lyubov Rychkova ◽  
Ekaterina Moskaleva ◽  
Evgeniya Novikova
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Social History ◽  
Vertical Transmission ◽  
Inflammatory Diseases ◽  
Virus Transmission ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Immunodeficiency Virus ◽  
Epidemiological Characteristics

The purpose of this study was to determine the features of the course of pregnancy, delivery, and the postpartum period in HIV-positive women with a high risk of HIV vertical transmission. Methods and Results: A retrospective, longitudinal cohort study of mother-child pairs for the period from 2017 to 2019 was conducted in the Irkutsk City Perinatal Center (level III). The clinical observation group included HIV-positive women (n=213) and their newborn children with a high risk of perinatal immunodeficiency virus transmission (n=214). The findings of the conducted study demonstrated that most HIV-seropositive women with a high risk of HIV vertical transmission had an aggravated social history, a high prevalence of pelvic inflammatory diseases, and a high incidence of opportunistic and AIDS-defining conditions. Evaluation of PMTCT preventive complex showed that the target parameters in women with a high risk of HIV transmission were not reached: the first stage was performed for 49.3% of pregnant women with good ART adherence, the second stage – for 97.1% of obstetric patients, the third stage – in 100% of HIV perinatally exposed children. HIV RNA was detected in 3.7% of children, which evidences their antenatal infection. Conclusion: Development of efficient communication with HIV-positive women aimed at preservation of their health and decrease of logistic barriers to access to medical care.

scholarly journals A study on cervical cytopathology in HIV positive pregnant women in Southern part of Assam, India

2021 ◽  
Vol 10 (9) ◽  
pp. 3490
Author(s):  
Arun Paul Choudhury ◽  
Tanaya Acharyya
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
High Viral Load ◽  
Antenatal Clinic ◽  
Hiv Positive ◽  
P Value ◽  
Cervical Lesions ◽  
Abnormal Cytology ◽  
Cd4 Cell Count ◽  
Hiv Negative

Background: The association between abnormal cervical cytology and HIV infection status in pregnant women was evaluated to correlate with CD4 cell count, viral load and ART compliance in HIV positive pregnant patients with the presence of ASC-US, LSIL and HSIL.Methods: Cervical samples were collected at the Antenatal Clinic of Silchar Medical College and Hospital. An Ayre’s spatula was used to collect samples from the ectocervix and a cytology brush to collect samples from the endocervix.Results: Of a total of 75 antenatal attendees, 43 were HIV positive and 32 were HIV negative. Abnormal cytology (N=26, 60.46%) was more common in HIV positive group compared to the HIV negative group (N=7, 21.87%) with a p value of <0.05. Cytological abnormalities were found to be associated with immunosuppression, defined as CD4 count <200 cells/mm3 and was also associated with high viral load(>10,000/mm3) and poor treatment follow up with ART.Conclusions: HIV positive pregnant women are more likely to have cervical lesions as compared to the HIV negative. This higher frequency of abnormal findings in PAP cytology in HIV positive pregnant women with higher viral loads suggest association between preinvasive cervical lesions and human immune deficiency.

scholarly journals High Prevalence of Human Papillomavirus Infection among Brazilian Pregnant Women with and without Human Immunodeficiency Virus Type 1

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Emilia Moreira Jalil ◽  
Geraldo Duarte ◽  
Patrícia El Beitune ◽  
Renata Toscano Simões ◽  
Patrícia Pereira dos Santos Melli ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Prevalence Ratio ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Hiv Negative

Objective. To estimate HPV prevalence among pregnant women from Ribeirão Preto, Brazil, and the possible influence of HIV-1 infection on this prevalence.Methods. A cross-sectional study with 44 HIV-positive and 53 HIV-negative pregnant women was conducted. Cervicovaginal specimens were obtained from all women during gynecologic exam. HPV DNA, low and high risk HPV types, was detected using conventional PCR. Statistical analysis used Student'st-test, Mann-Whitney test, Fischer's Exact test, and prevalence ratios with 95% confidence interval.Results. HIV-positive pregnant women had higher proportion of HPV infection than HIV-negative pregnant women (79.5% versus 58.5%;P<.05). HPV positivity prevalence ratio for HIV-positive women was 1.36 (95% CI 1.04–1.8;P=.03). There was significant association between HIV viral load levels and HPV positivity (P<.05).Conclusions. Our results demonstrate higher HPV positivity in HIV-infected pregnant women. Higher values of HIV viral load were associated with HPV positivity.

scholarly journals Assessment of Antiretroviral therapy Initiation among pregnant Women under Option B+ Approach; Viral Load and CD4 Count Outcomes in selected Hospitals of West Zone Oromia, Ethiopia: Quantitative Prospective Cohort Study Design

2019 ◽  
Author(s):  
Dereje Bayissa Demissie ◽  
Gizachew Abdissa Bulto ◽  
Wagi Tosisa Mekuria ◽  
Fikru Negassa Dufera
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Treatment Outcomes ◽  
Prospective Cohort ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Virologic Suppression ◽  
Art Initiation ◽  
Study Results

Abstract Abstract Background: Antiretroviral therapy (ART) is effective for elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) infection, reducing infant mortality and ensuring maternal virologic suppression. While pregnant women require lifelong ART immediately they test HIV positive (“test and treat”) under Option B+ programs, eMTCT programs face challenges and information on the relationship between the time to ART initiation following HIV testing and treatment outcomes is limited in Ethiopia Methods: A quantitative prospective cohort design was employed to conduct the study. Five randomly selected Hospitals providing Option B+ services with routine viral load assessment by Oromia regional Laboratory (ORL) from January 2016 to January 2017 was randomly selected. Bivariate and multivariable analyses were conducted to determine factors affecting the time to ART initiation following an HIV test and logistic regression used to determine the correlation between time and treatment outcomes. Results: The study results produced and evidence of a mean VL (copies/ml) of 197.27 copies/ml. Respondents that were on ART for a shorter period ≤37 months had the least proportion of women 31% were suppressed with VL<1000 copies/ml compared to those on ART for >38 months (58.7%) were suppressed. The median (IQR) CD4 count change or difference among women that had initial and last CD4 was 581 cells/μl and mean of current CD4 count 629.17ceels/ml3 and more than 85.3% had increase CD4 count. Therefore, in this study identified that factors associated with viral load response were poor /fair adherence missing doses in the past month, missing appointments, baseline CD4 and maternal months on ART were statistically significant among HIV positive pregnant women that initiated lifelong ART on option B+ in Ethiopia. Conclusion: The study results demonstrated that HIV positive pregnant women Study results indicate that majority of the respondents 89.7% were suppressed of which 80.3% were undetectable (VL= 0 copies /ml3 and 85.3% had increased CD4 count and 10.3% were not suppressed (VL >1000 copies/ml). Therefore, strategies aimed at improving adherence among women on option B+ are to ensure that these women achieve adequate immunological outcomes. Keywords: ART Initiation Pregnant Women Option B +, Viral Load, CD4 Count

Barriers to achieving undetectable viral load in HIV-positive pregnant women at the time of delivery: The Swiss Mother & Child HIV Cohort Study

2013 ◽  
Vol 217 (S 01) ◽  
Author(s):  
K Aebi-Popp ◽  
T Glass ◽  
C Rudin ◽  
B Bertisch ◽  
B Martinez de Tejada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Pregnant Women ◽  
Undetectable Viral Load ◽  
Hiv Positive

scholarly journals Epidemiology of HPV in HIV-Positive and HIV-Negative Fertile Women in Cameroon, West Africa

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Andrew J. Desruisseau ◽  
Delf Schmidt-Grimminger ◽  
Edith Welty
Keyword(s):  
High Risk ◽  
Quadrivalent Vaccine ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Hiv Positive Women ◽  
Current Vaccine ◽  
High Risk Hpv ◽  
Oncogenic Hpv ◽  
Hiv Negative

Background. HPV types vary by country and HIV status. There are no data on the prevalent HPV genotypes from Cameroon.Methods. We conducted a cross-sectional, observational study on 65 Cameroonian women. Samples were sent for HPV genotyping and Thin Prep analyses.Results. 41 out of 61 samples tested (67.2%) had HPV subtypes detected. The most common high risk types encountered were: 45 (24.6%) and 58 (21.5%). HIV-positive women were more likely to test positive for any HPV (P=.014), have more than one HPV subtype (P=.003), and to test positive for the high risk subtypes (P=.007). Of those with high risk HPV, HIV-positive women were more likely to have Thin Prep abnormalities than HIV-negative women (P=.013).Conclusions. Oncogenic HPV subtypes 45 and 58 were more prevalent than those subtypes carried in the quadrivalent vaccine. Further studies are needed to assess whether the current vaccine will be effective in this region.

Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil

2021 ◽  
Author(s):  
Mariana Menegotto ◽  
Amanda M. Magdaleno ◽  
Carmem L.O. da Silva ◽  
Luciana Friedrich ◽  
Clécio H. da Silva
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Porto Alegre ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Mtct Rate ◽  
Peripartum Period ◽  
Mother To Child

Objective Most of the HIV pediatric infections are acquired through mother-to-child transmission (MTCT). Porto Alegre is a state capital of Brazil that had a HIV MTCT rate of 4.1% in 2013 and the highest rate of HIV-infected pregnant women in the country during 2018. Zidovudine and nevirapine have been used in Brazil for high-risk newborns since 2012. The aim of the study was to investigate HIV MTCT rate and the factors associated with HIV transmission at a hospital that is a reference center for HIV-infected mothers in Porto Alegre, after the introduction of this policy. Study Design This retrospective cohort study included all HIV-exposed infants born between February 2013 and December 2016 at the Hospital de Clínicas de Porto Alegre. Student's t-test or Fisher's exact test was used to compare variables between HIV-infected and uninfected groups of newborns. Poisson's regression with robust variance was used to determine the factors associated with HIV MTCT. Results A total of 375 newborns were exposed to HIV, with an outpatient loss of 14.4% (n = 54). The HIV MTCT rate was 2.18% (n = 7), with four infected during the intrauterine period. The risk factors for MTCT were no prenatal care (relative risk [RR] = 9.4; 95% confidence interval [CI]: 2.0–44.3), late maternal HIV diagnosis in the peripartum period (RR = 16.3; 95% CI: 3.6–73.0), syphilis infection during pregnancy (RR = 9.3; 95% CI: 2.1–40.3), maternal viral load >1,000 copies/mL in the third trimester or peripartum period (RR = 9.5; 95% CI: 1.7–50.5), and lack of or inappropriate antiretroviral therapy during pregnancy (RR = 8.2; 95% CI: 1.6–41.4). Conclusion MTCT rate was 2.18%. With the institution of two-drug prophylaxis for high-risk newborns, persistent cases HIV MTCT were predominantly found among women with absence of antenatal care, late HIV diagnosis, syphilis coinfection, high viral load, and inadequate ARV therapy during pregnancy. Although zidovudine and nevirapine were administered postnatally to high-risk newborns, this regimen could not prevent transplacental transmission. Key Points

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