scholarly journals Assessing the effectiveness of prevention of mother-to-child HIV transmission

2021 ◽  
Vol 102 (2) ◽  
pp. 176-184
Author(s):  
R M Khamidulina ◽  
M G Katyagina ◽  
I S Zolotova ◽  
L E Ziganshina
Keyword(s):  
Hiv Infection ◽  
Vertical Transmission ◽  
Hiv Transmission ◽  
Single Case ◽  
Hiv Diagnosis ◽  
Infected Woman ◽  
Entire Study ◽  
Antiretroviral Prophylaxis ◽  
Maternal Hiv ◽  
The Republic

Aim. To analyze the outcomes of a set of interventions to prevent vertical transmission of the human immunodeficiency virus (HIV) in the Republic of Mari El. Methods. A retrospective analysis of temporary registration forms Notifications of the termination of pregnancy in an HIV-infected woman and Notifications of a newborn born by an HIV-infected mother, case histories and outpatient medical records of HIV-infected women who gave birth in 20002018 was carried out. The study included all children born in the Republic of Mari El to HIV-positive women registered with the Republican Center for the Prevention and Control of AIDS and Infectious Diseases, as well as children whose HIV status is detected after birth as a result of epidemiological investigations. The assessment of the risks of transmission as an outcome of the three-step preventive interventions has been carried out. A comparative analysis of the results of perinatal prevention of HIV transmission in the Republic of Mari El and other regions of the Russian Federation was performed. Results. A total of 299 HIV-infected pregnant women and 368 children born to these women during the study period were registered in the region; 63 (21.7%) of these women had more than one child. Over the entire study period, 18 (4.8%) children with confirmed HIV infection were registered. The most common factor associated with infant HIV infection is late maternal HIV diagnosis: (1) several years after childbirth in the absence of antiretroviral (ARV) prophylaxis and the infants were breastfeeding (11 cases, 64.7%); (2) during or shortly after childbirth, when the patient did not receive entire three-step antiretroviral prophylaxis during pregnancy and childbirth (6 cases, 29.4%); (3) in the third trimester of pregnancy (1 case, 5.5%). An important limitation for the successful prevention of vertical transmission of HIV was the lack of routine HIV testing, which is required by women and their partners before and at various stages during pregnancy. A single case of self-infection indicates the need to introduce preventive measures from early adolescence among children. Conclusion. Due to the late maternal HIV diagnosis, during or after delivery, HIV transmission events occurred either with limited or no limited antiretroviral prophylaxis.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

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 Trends in Women With an HIV Diagnosis at Delivery Hospitalization in the United States, 2006-2014

2020 ◽  
Vol 135 (4) ◽  
pp. 524-533
Author(s):  
Maria Vyshnya Aslam ◽  
Kwame Owusu-Edusei ◽  
Steven R. Nesheim ◽  
Kristen Mahle Gray ◽  
Margaret A. Lampe ◽  
...  
Keyword(s):  
Black Women ◽  
Hiv Infection ◽  
White Women ◽  
Hiv Transmission ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Adjusted Relative Risk ◽  
Hiv Diagnosis ◽  
Mother To Child ◽  
Privately Insured

Objectives The risk of mother-to-child HIV transmission can be reduced to ≤0.5% if the mother’s HIV status is known before delivery. This study describes 2006-2014 trends in diagnosed HIV infection documented on delivery discharge records and associated sociodemographic characteristics among women who gave birth in US hospitals. Methods We analyzed data from the 2006-2014 National Inpatient Sample and identified delivery discharges and women with diagnosed HIV infection by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used a generalized linear model with log link and binomial distribution to assess trends and the association of sociodemographic characteristics with an HIV diagnosis on delivery discharge records. Results During 2006-2014, an HIV diagnosis was documented on approximately 3900-4400 delivery discharge records annually. The probability of having an HIV diagnosis on delivery discharge records decreased 3% per year (adjusted relative risk [aRR] = 0.97; 95% CI, 0.94-0.99), with significant declines identified among white women aged 25-34 (aRR = 0.93; 95% CI, 0.88-0.97) or those using Medicaid (aRR = 0.93; 95% CI, 0.90-0.97); among black women aged 25-34 (aRR = 0.95; 95% CI, 0.92-0.99); and among privately insured women who were black (aRR = 0.96; 95% CI, 0.92-0.99), Hispanic (aRR = 0.92; 95% CI, 0.86-0.98), or aged 25-34 (aRR = 0.96; 95% CI, 0.92-0.99). The probability of having an HIV diagnosis on delivery discharge records was greater for women who were black (aRR = 8.45; 95% CI, 7.56-9.44) or Hispanic (aRR = 1.56; 95% CI, 1.33-1.83) than white; for women aged 25-34 (aRR = 2.33; 95% CI, 2.12-2.55) or aged ≥35 (aRR = 3.04; 95% CI, 2.79-3.31) than for women aged 13-24; and for Medicaid recipients (aRR = 2.70; 95% CI, 2.45-2.98) or the uninsured (aRR = 1.87; 95% CI, 1.60-2.19) than for privately insured patients. Conclusion During 2006-2014, the probability of having an HIV diagnosis declined among select sociodemographic groups of women delivering neonates. High-impact prevention efforts tailored to women remaining at higher risk for HIV infection can reduce the risk of mother-to-child HIV transmission.

Prevention of Mother-to-Child HIV Transmission in Nigeria: Six Years Experience from a Tertiary Institution

2021 ◽  
Vol 19 ◽  
Author(s):  
Rabiu Ibrahim Jalo ◽  
Taiwo Amole ◽  
Deepa Dongarwar ◽  
Hadiza Abdullahi ◽  
Fatima I. Tsiga-Ahmed ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Infection Rate ◽  
Hiv Transmission ◽  
Early Infant Diagnosis ◽  
Mixed Feeding ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Antiretroviral Prophylaxis ◽  
Hiv Exposed ◽  
Mother To Child

Background: In line with global standards and progress made in Prevention of Mother-to-Child Transmission (PMTCT), an assessment of the outcome of Early Infant Diagnosis in northern Nigeria is necessary to evaluate progress towards a zero Human immunodeficiency Virus (HIV) infection rate among children. Objectives: This study assessed the infection rate and risk factors for mother-to-child HIV transmission among HIV-exposed children in Kano, northwest Nigeria. Method: Using a retrospective cohort design, pregnant HIV-positive women and their exposed infants were recruited over a period of six years (2010 to 2016). Participants were enrolled during pregnancy or at delivery from the PMTCT clinic of a tertiary health facility in Kano, Nigeria. The main observations of the study were Early infant diagnosis positivity for HIV at 6 weeks and the risk factors for positivity. Results: Of the 1,514 infants studied, Early Infant Diagnosis was positive for HIV among 13 infants (0.86%). Infants whose mothers did not have antiretroviral therapy (adjusted Prevalence Ratio aPR = 2.58, 95%CI [1.85- 3.57]); who had mixed feeding (aPR = 12.06, 95%CI [9.86- 14.70]) and those not on antiretroviral prophylaxis (aPR = 20.39, 95%CI [16.04- 25.71]) were more likely to be infected with HIV. HIV-exposed infants on nevirapine and zidovudine prophylaxis accounted for 95% and 74%, respectively, and were less likely to be infected with HIV. Conclusion: HIV infection rate remains high among HIV-exposed infants whose mothers did not receive PMTCT services. Scaling up proven interventions of early commencement of antiretroviral treatment for mothers, adherence to antiretroviral prophylaxis and avoidance of mixed feeding among HIV-exposed infants would protect future generations from HIV infection.

Maternal HIV Infection and Vertical Transmission of Pathogenic Bacteria

PEDIATRICS ◽  
2012 ◽  
Vol 130 (3) ◽  
pp. e581-e590 ◽  
Author(s):  
C. L. Cutland ◽  
S. J. Schrag ◽  
E. R. Zell ◽  
L. Kuwanda ◽  
E. Buchmann ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Vertical Transmission ◽  
Pathogenic Bacteria ◽  
Maternal Hiv ◽  
Maternal Hiv Infection

Mechanisms of HIV Transmission

2019 ◽  
pp. 21-24
Author(s):  
Puja Nambiar ◽  
William R. Short
Keyword(s):  
Viral Load ◽  
Relative Risk ◽  
Drug Use ◽  
Hiv Infection ◽  
Sexual Activity ◽  
Vertical Transmission ◽  
Hiv Transmission ◽  
Occupational Exposures ◽  
Transmission Risk

Upon completion of this chapter, the reader should be able to • Describe the relative risk of acquiring HIV infection based on various types of sexual activity, occupational exposures, drug use, and vertical transmission • Discuss the significance of viral load quantity and its relationship to transmission risk...

scholarly journals Care of the HIV-infected pregnant woman in the developed world

2014 ◽  
Vol 8 (1) ◽  
pp. 13-17
Author(s):  
Erica Hardy ◽  
Susan Cu-Uvin
Keyword(s):  
Hiv Transmission ◽  
Modern Medicine ◽  
Preconception Counseling ◽  
Missed Opportunities ◽  
Infected Woman ◽  
Hiv Counseling ◽  
Success Stories ◽  
Counseling And Testing ◽  
Antiretroviral Prophylaxis ◽  
Developed World

The reduction of human immunodeficiency virus (HIV) transmission from mother to child is one of the success stories of modern medicine and public health. In the developed world, with universal HIV counseling and testing, antiretroviral prophylaxis, scheduled Caesarean delivery if indicated, and avoidance of breastfeeding, HIV transmission from mother to infant can be <2%. Despite this, transmissions continue to occur, often due to lack of knowledge of HIV status. Missed opportunities for prevention and prevention challenges include late prenatal care, lack of HIV testing in pregnancy, lack of preconception counseling, unintended pregnancy, and substance abuse. We review preconception counseling including options for serodiscordant couples, and antepartum, peripartum and postpartum care of the HIV-infected woman in the developed world, and advocate for a comprehensive, collaborative, multidisciplinary approach.

Maternal HIV-1 viral load and vertical transmission of infection: The Ariel Project for the prevention of HIV transmission from mother to infant

1997 ◽  
Vol 3 (5) ◽  
pp. 549-552 ◽  
Author(s):  
Yunzhen Cao ◽  
Paul Krogstad ◽  
Bette T. Korber ◽  
Richard A. Koup ◽  
Mark Muldoon ◽  
...  
Keyword(s):  
Viral Load ◽  
Vertical Transmission ◽  
Hiv Transmission ◽  
Maternal Hiv ◽  
Hiv 1 ◽  
Prevention Of Hiv

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.

scholarly journals Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016

2017 ◽  
Vol 22 (48) ◽  
Author(s):  
Ard van Sighem ◽  
Anastasia Pharris ◽  
Chantal Quinten ◽  
Teymur Noori ◽  
Andrew J Amato-Gauci ◽  
...  
Keyword(s):  
European Union ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Linkage To Care ◽  
European Economic Area ◽  
The European Union ◽  
Hiv Diagnosis ◽  
European Economic ◽  
Economic Area ◽  
Undiagnosed Hiv

It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3).

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