scholarly journals Parity and its effect on the CD4+ count of hiv-seronegative pregnant women attending Adeoyo hospital, Ibadan, Nigeria

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Ayodele O Ilesanmi ◽  
Okezie C Okamgba ◽  
Kikelomo Oyeleke ◽  
Arinze Anyiam ◽  
Blessing Ayegoro
Keyword(s):  
Pregnant Women ◽  
Cd4 Count ◽  
Ibadan Nigeria

scholarly journals Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Barbara Castelnuovo ◽  
Frank Mubiru ◽  
Ivan Kalule ◽  
Shadia Nakalema ◽  
Agnes Kiragga
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
Median Time ◽  
Hiv Transmission ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Hiv Positive Women

Since 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from January 2012 to August 2014 with a follow-up extended to August 2016; the median age was 31 years (IQR: 26–35), 36.3% in WHO stage 3/4; median CD4 count was 447 cells/μL (IQR: 301–651) and 73.3% were already on ART for a median time of 28 (IQR: 10–57) months; 52% infants were male and median weight was 3.2 Kg (IQR: 2.5–3.5). Five hundred and sixty-five (80.7%) infants had at least one test for HIV; 22 (3.1%) infants died, all with unknown serostatus; 3 tested positive at week 6 and one additional at months 12 and 18. Two of the mothers of the 4 HIV-positive infants were ART-naïve at the time of pregnancy. We report very low documented HIV transmission comparable with those reported in clinical trials settings; however, demonstrating the efficacy of Option B-plus in terms of averted transmission in routine settings is challenging since high proportion of infants do not have documented HIV tests.

scholarly journals Prevalence of HIV in a Cohort of Pregnant Women Attending a Tertiary Hospital in Ibadan, Nigeria

2019 ◽  
Vol 7 (1) ◽  
pp. 7-12
Author(s):  
Iheanyi O. Okonko ◽  
Anwuli U. Osadebe ◽  
Okechukwu Onianwa ◽  
Stella Okereke
Keyword(s):  
Pregnant Women ◽  
Tertiary Hospital ◽  
Ibadan Nigeria

scholarly journals Pregnancy outcomes in sexually transmitted infections or human immunodeficiency viruses infected women at a tertiary care center: a retrospective study

2021 ◽  
Vol 7 (2) ◽  
pp. 229
Author(s):  
Saradha K. P. ◽  
Anitha Christy Stephen ◽  
Vikram V. Huddar
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adverse Pregnancy Outcomes ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Normal Delivery ◽  
Adverse Pregnancy

<p><strong>Background: </strong>The natural history of HIV infection in early disease is not affected by pregnancy. In later stages there may be rapid disease progression leading to adverse pregnancy outcomes. Prevalence of HIV in India is 0.3% in pregnant women. With the advent of PPTCT, there have been a decline in the adverse pregnancy outcomes but still few adversities are reported.  Aim of the study was to assess the various pregnancy outcomes in HIV positive women and the effects of antiretroviral therapy (ART).</p><p><strong>Methods: </strong>A retrospective analytical study conducted from July 2017-June 2019 on HIV infected pregnant women. Their maternal age, CD4 count at diagnosis of HIV, after postpartum, mode of delivery, birth weight and HIV status of baby were noted and analyzed.  <strong></strong></p><p><strong>Results: </strong>18 HIV infected pregnant women were included. Their mean age was 25.6 years. 12 patients were in 2<sup>nd</sup> trimester and the rest in 1<sup>st</sup> trimester. All were on triple-drug (TEL) regimen. Three were diagnosed with HIV prior to conception and were already on ART. Remaining were detected at the time of ANC visit. All cases fall under stage I WHO clinical staging. Out of the 18 pregnant, two delivered by LSCS and the rest by normal delivery. All were term deliveries, with mean birth weight of 2.82 kg. One HIV infected baby was born by LSCS. The mean CD4 count at the time of diagnosis of HIV was 389 and at postpartum was 508. Overall, there was seen to be an increase in CD4 count without any adverse effects during ART.<strong></strong></p><p><strong>Conclusions: </strong>Prompt HIV diagnosis and ART initiation during antenatal period can have good pregnancy outcome and thereby reducing transmission to children.</p>

scholarly journals Thai national guidelines for the prevention of motherto- child transmission of HIV: March 2010

2010 ◽  
Vol 4 (4) ◽  
pp. 529-540 ◽  
Author(s):  
Nittaya Phanuphak ◽  
Rangsima Lolekha ◽  
Kulkanya Chokephaibulkit ◽  
Nipunporn Voramongkol ◽  
Sarawut Boonsuk ◽  
...  
Keyword(s):  
Single Dose ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Transmission Rate ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Child Transmission ◽  
Term Care

Abstract Thailand has been one of the leading developing countries to implement a national program to prevent mother-to-child transmission (MTCT) of HIV. Although the recent transmission rate has been low, the goal is to eliminate MTCT altogether. The Thai National HIV Guidelines Working Group issued treatment guidelines to prevent MTCT in Thailand in March 2010. These guidelines will be implemented nationwide within a year. The most important aspects of these new guidelines are as follows: Treatment in HIV-infected pregnant women who have not been on antiretroviral treatment prior to pregnancy. Antepartum treatment is recommended for all pregnant women regardless of CD4 count with highly active antiretroviral therapy (HAART) containing zidovudine (AZT) + lamivudine (3TC) + lopinavir/ritonavir (LPV/r). Treatment should be started immediately irrespective of gestational age in women with CD4 count <350 cells/ mm3, and as early as 14 weeks of gestation in those with CD4 count >350 cells/mm3. After delivery, women with baseline CD4 count <350 cells/mm3 are referred for long-term care and HAART according to the National Adult HIV Treatment and Care Guidelines 2010. Women with CD4 count >350 cells/mm3 do not need HAART and can stop all drugs after delivery. The treatment in infants includes AZT syrup for four weeks and exclusive formula feeding. Treatment in HIV-infected pregnant women who conceive while on HAART. Women who are stable on HAART should continue the treatment during the whole period of pregnancy. Those who are taking efavirenz (EFV) and present during the first trimester should have EFV switched to another drug. Whenever possible, AZT should be used during pregnancy. Treatment in infants is similar to the above scenario. Treatment in women who present in labor without antenatal care. Single-dose nevirapine (SD-NVP) 200 mg must be given immediately along with oral AZT 300 mg every three hours until delivery, or oral AZT 600 mg given as a single dose. The tail therapy of AZT + 3TC + LPV/r for four weeks should be given unless these women have a CD4 count of <350 cells/mm3 and therefore require life-long HAART. SD-NVP should not be given if the women are to deliver within two hours. The infants in this situation should receive AZT + 3TC + NVP for four weeks. Treatment during delivery and mode of delivery. During labor, oral AZT 300 mg every three hours or oral AZT 600 mg given as a single dose is recommended regardless of antepartum antiretroviral (ARV) regimen or the woman’s history of AZT resistance. Elective caesarean section is suggested in women who did not receive HAART (including those without antenatal care), received HAART for less than four weeks prior to delivery, had poor adherence, or had incomplete viral suppression at 36 weeks of gestation.

scholarly journals Safety and Effectiveness of Isoniazid Preventive Therapy in Pregnant Women Living with Human Immunodeficiency Virus on Antiretroviral Therapy: An Observational Study Using Linked Population Data

2020 ◽  
Vol 71 (8) ◽  
pp. e351-e358 ◽  
Author(s):  
Emma Kalk ◽  
Alexa Heekes ◽  
Ushma Mehta ◽  
Renee de Waal ◽  
Nisha Jacob ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Absolute Risk ◽  
First Trimester ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Isoniazid Preventive Therapy ◽  
Immunodeficiency Virus

Abstract Background Isoniazid preventive therapy (IPT) is widely used to protect against tuberculosis (TB) in people living with human immunodeficiency virus (HIV). Data on the safety and efficacy of IPT in pregnant women living with HIV (PWLHIV) are mixed. We used an individual-level, population-wide health database to examine associations between antenatal IPT exposure and adverse pregnancy outcomes, maternal TB, all-cause mortality, and liver injury during pregnancy through 12 months postpartum. Methods We used linked routine electronic health data generated in the public sector of the Western Cape, South Africa, to define a cohort of PWLHIV on antiretroviral therapy. Pregnancy outcomes were assessed using logistic regression; for maternal outcomes we applied a proportional hazards model with time-updated IPT exposure. Results Of 43 971 PWLHIV, 16.6% received IPT. Women who received IPT were less likely to experience poor pregnancy outcomes (adjusted odds ratio [aOR], 0.83 [95% confidence interval {CI}, .78–.87]); this association strengthened with IPT started after the first trimester compared with none (aOR, 0.71 [95% CI, .65–.79]) or with first-trimester exposure (aOR, 0.64 [95% CI, .55–.75]). IPT reduced the risk of TB by approximately 30% (aHR, 0.71 [95% CI, .63–.81]; absolute risk difference, 1518/100 000 women). The effect was modified by CD4 cell count with protection conferred if CD4 count was ≤350 cells/μL (aHR, 0.51 [95% CI, .41–.63]) vs 0.93 [95% CI, .76–1.13] for CD4 count &gt;350 cells/µL). Conclusions This analysis of programmatic data is reassuring regarding the safety of antenatal IPT, with the greatest benefits against TB disease observed in women with CD4 count ≤350 cells/μL.

scholarly journals The Effect of Cotrimoxazole Prophylactic Treatment on Malaria, Birth Outcomes, and Postpartum CD4 Count in HIV-Infected Women

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Dow ◽  
Dumbani Kayira ◽  
Michael G. Hudgens ◽  
Annelies Van Rie ◽  
Caroline C. King ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Prophylactic Treatment ◽  
Proportional Hazards ◽  
Preventive Therapy ◽  
Hazard Ratio ◽  
Cd4 Count ◽  
Malaria During Pregnancy

Background. Limited data exist on cotrimoxazole prophylactic treatment (CPT) in pregnant women, including protection against malaria versus standard intermittent preventive therapy with sulfadoxine-pyrimethamine (IPTp).Methods. Using observational data we examined the effect of CPT in HIV-infected pregnant women on malaria during pregnancy, low birth weight and preterm birth using proportional hazards, logistic, and log binomial regression, respectively. We used linear regression to assess effect of CPT on CD4 count.Results. Data from 468 CPT-exposed and 768 CPT-unexposed women were analyzed. CPT was associated with protection against malaria versus IPTp (hazard ratio: 0.35, 95% Confidence Interval (CI): 0.20, 0.60). After adjustment for time period this effect was not statistically significant (adjusted hazard ratio: 0.66, 95% CI: 0.28, 1.52). Among women receiving and not receiving CPT, rates of low birth weight (7.1% versus 7.6%) and preterm birth (23.5% versus 23.6%) were similar. CPT was associated with lower CD4 counts 24 weeks postpartum in women receiving (−77.6 cells/μL, 95% CI: −125.2, −30.1) and not receiving antiretrovirals (−33.7 cells/μL, 95% CI: −58.6, −8.8).Conclusions. Compared to IPTp, CPT provided comparable protection against malaria in HIV-infected pregnant women and against preterm birth or low birth weight. Possible implications of CPT-associated lower CD4 postpartum warrant further examination.

scholarly journals Hepatitis B virus infection among pregnant women on antenatal visits: rapid tests or ELISA?

2021 ◽  
Vol 22 (3) ◽  
pp. 352-358
Author(s):  
A. Fowotade ◽  
S.O. Adetunji ◽  
E. Amadi ◽  
I.O. Ishola ◽  
E.C. Omoruyi
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Rapid Screening ◽  
Virus De L’Hépatite B ◽  
Femmes Enceintes ◽  
B Virus ◽  
Antenatal Visits ◽  
Hbv Screening ◽  
Ibadan Nigeria

Background: Hepatitis B virus (HBV) infection is a global public health challenge with over 360 million people infected worldwide, and is one of the leading causes of death worldwide. The hepatitis B surface antigen (HBSAg) is the most important marker for HBV screening, and HBSAg rapid screening test methods are the most widely used compared with the enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing methods. The objectives of this study are to evaluate the comparative efficacy of rapid test kits and ELISA for HBV screening among pregnant women on antenatal visits and to screen for other HBV serological markers among HBsAg positive patients. Methodology: This is a cross-sectional study of 172 pregnant women who were recruited consecutively on their first antenatal visit at the University College Hospital, Ibadan, Nigeria between November 2018 and February 2019. All participants were screened for HBsAg using both rapid immunochromatographic test (ICT) and ELISA techniques. HBsAg negative samples were further screened for anti-HBeAg/Ab, anti-HBcAg and anti-HBs by ELISA. Socio-demographic data of the participants were obtained using a semi-structured questionnaire, and data were analyzed using EPI INFO 7.2 statistical software. Results: The prevalence rate of HBsAg among pregnant women in this study was 10.5% (18/172). The sensitivity, specificity, accuracy, positive predictive value (PPV) and the negative predictive value (NPV) of the rapid ICT kit were 72.2%, 97.4%, 94.8%, 76.5% and 96.8% respectively. Level of education, previous history of sexually transmitted infections (STIs) and previous positive HBV results were significantly associated with HBsAg seropositivity. Majority of the pregnant women (66.9%) tested negative to all the serological markers. Conclusion: The low efficacy of rapid ICT kits compared to ELISA justifies the need to develop a safer antenatal screening strategy for HBV by combining the use of the less sensitive rapid screening techniques with the more sensitive ELISA method to limit vertical transmission of hepatitis B virus. Keywords: Hepatitis B virus; Rapid ICT kits; ELISA; pregnant women   French title: Infection par le virus de l'hépatite B chez les femmes enceintes en consultation prénatale: tests rapides ou ELISA? Contexte: L'infection par le virus de l'hépatite B (VHB) est un défi de santé publique mondial avec plus de 360 million de personnes infectées dans le monde et est l'une des principales causes de décès dans le monde. L'antigène de surface de l'hépatite B (HBSAg) est le marqueur le plus important pour le dépistage du VHB, et les méthodes de test de dépistage rapide HBSAg sont les plus largement utilisées par rapport aux méthodes de test immuno-enzymatique (ELISA) et d'acide nucléique. Les objectifs de cette étude sont d'évaluer l'efficacité comparative des kits de tests rapides et de l'ELISA pour le dépistage du VHB chez les femmes enceintes lors de consultations prénatales et de dépister d'autres marqueurs sérologiques du VHB chez les patients AgHBs positifs. Méthodologie: Il s'agit d'une étude transversale de 172 femmes enceintes qui ont été recrutées consécutivement lors de leur première visite prénatale à l'Hôpital Universitaire, Ibadan, Ibadan, Nigéria entre novembre 2018 et février 2019. Tous les participants ont été dépistés pour l'AgHBs en utilisant les deux tests immuno-chromatographiques rapides (TIC) et techniques ELISA. Les échantillons négatifs à l'AgHBs ont en outre été criblés pour l'anti-HBeAg/Ab, l'anti-HBcAg et l'anti-HBs par ELISA. Les données sociodémographiques des participants ont été obtenues à l'aide d'un questionnaire semi-structuré et les données ont été analysées à l'aide du logiciel statistique EPI INFO 7.2. Résultats: Le taux de prévalence de l'HBSAg chez les femmes enceintes dans cette étude était de 10,5% (18/172). La sensibilité, la spécificité, la précision, la valeur prédictive positive (VPP) et la valeur prédictive négative (VPN) du kit ICT rapide étaient respectivement de 72,2%, 97,4%, 94,8%, 76,5% et 96,8%. Le niveau d'éducation, les antécédents d'infections sexuellement transmissibles (IST) et les résultats positifs antérieurs pour le VHB étaient significativement associés à la séropositivité de l'AgHBs. La majorité des femmes enceintes (66,9%) ont été testées négatives pour tous les marqueurs sérologiques. Conclusion: La faible efficacité des kits TIC rapides par rapport à l'ELISA justifie la nécessité de développer une stratégie de dépistage prénatal plus sûre du VHB en combinant l'utilisation des techniques de dépistage rapide moins sensibles avec la méthode ELISA plus sensible pour limiter la transmission verticale du virus de l'hépatite B. Mots clés: virus de l'hépatite B; Kits TIC rapides; ELISA; femmes enceintes

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