scholarly journals HIV in pregnancy

2021 ◽  
Vol 10 (3) ◽  
pp. 1241
Author(s):  
Gauri S. Kore
Keyword(s):  
Vertical Transmission ◽  
Hiv Transmission ◽  
Signs And Symptoms ◽  
The Body ◽  
Viral Therapy ◽  
Vertical Transmission Of Hiv ◽  
Living With Hiv ◽  
First Time ◽  
Mother To Child ◽  
Triple Dose

HIV is a disease caused by retrovirus (HIV-1 or HIV-2) the that attacks the immune system of the body, leaving it susceptible to various dangerous infections. HIV can have profound effects on pregnancy and pregnancy may in turn cause an aggravation of signs and symptoms HIV.A pregnant woman living with HIV can pass on the virus to her baby during pregnancy, childbirth and through breastfeeding. This is called Vertical transmission of HIV. Without any intervention, the rate of vertical transmission of HIV is as much as 15-45%. National PPTCT program of India run by NACO (National AIDS Control Organization) aims at preventing HIV transmission from mother to child. Women who are known HIV positives or those who are diagnosed as HIV positive for the first-time during pregnancy, are given Triple Dose Anti Retro-viral therapy comprising of Tenofovir, Lamivudine and Efavirenz. Special precautions are taken during their delivery. Whether LSCS is to be performed depends on the indications and on which guidelines are followed. Infant- feeding is advised to be carried out as per the guidelines stated in the PPTCT act so as to minimize the chances of HIV transmission to the infant.

Antiretroviral Therapy in Pregnant Women

2019 ◽  
pp. 281-286
Author(s):  
William R. Short ◽  
Jason J. Schafer
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Pediatric Aids ◽  
Women Living With Hiv ◽  
Pivotal Study ◽  
Aids Clinical Trials ◽  
Living With Hiv ◽  
Mother To Child ◽  
Over Time

Upon completion of this chapter, the reader should be able to describe the appropriate management of antiretrovirals for pregnant women living with HIV. Over time, research has demonstrated that proper prevention strategies and interventions during pregnancy, labor, and delivery can significantly reduce the rate of mother-to-child transmission (MTCT) of HIV. In 1994, a pivotal study in the field of HIV medicine, the Pediatric AIDS Clinical Trials Group 076, demonstrated that the use of zidovudine (ZDV) monotherapy during pregnancy substantially reduced the risk of HIV transmission to infants by 67% (...

scholarly journals Applying Quality Improvement Approaches to Reduce Mother-to-Child HIV Transmission and Improve Health and Nutrition Care in Five Countries: Lessons from the Partnership for HIV-Free Survival

2019 ◽  
Vol 18 ◽  
pp. 232595821984745
Author(s):  
Amy F. Stern ◽  
Anisa Ismail ◽  
Esther Karamagi ◽  
Tamara Nsubuga-Nyombi ◽  
Stella Kasindi Mwita ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Hiv Transmission ◽  
Retention In Care ◽  
Complex Problem ◽  
World Health ◽  
Free Survival ◽  
Hiv Positive Women ◽  
Vertical Transmission Of Hiv ◽  
Health Organization ◽  
Mother To Child

The World Health Organization guidelines for treating pregnant HIV-positive women and preventing HIV transmission to infants now recommend lifelong antiretroviral treatment for pregnant and breastfeeding women. We applied quality improvement (QI) methods to support governments and facility staff to address service gaps in 5 countries under the Partnership for HIV-Free Survival (PHFS). We used 3 key strategies: break the complex problem of improving HIV-free survival into more easily implementable phases, support a national management team to oversee the project, and support facility-level staff to learn and apply QI methods to reducing mother-to-child transmission. The key results in each country were increases in data completeness and accuracy, increases in retention in care of mother–baby pairs (MBPs), increase in coverage of MBPs with appropriate services, and reduction in vertical transmission of HIV. The PHFS experience offers a model that other multicountry networks can adopt to improve service delivery and quality of care.

scholarly journals HIV Status and Contraceptive Utilization among Women in Cameroon

2019 ◽  
Vol 18 ◽  
pp. 232595821982659 ◽  
Author(s):  
Henna Budhwani ◽  
Kristine Ria Hearld ◽  
Jodie Dionne-Odom ◽  
Simon Manga ◽  
Kathleen Nulah ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Hiv Transmission ◽  
Multivariate Analyses ◽  
Hiv Status ◽  
Improve Population Health ◽  
Women Living With Hiv ◽  
Contraceptive Utilization ◽  
Living With Hiv ◽  
Mother To Child ◽  
Hiv Negative

Objective: We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers. Methods: Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant. Results: Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001). Conclusion: Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.

scholarly journals Feedback-guided Development for Patient Education Animation: HIV Transmission via Breastfeeding

2018 ◽  
Vol 42 (2) ◽  
Author(s):  
Sarah Crawley ◽  
Shelley Wall ◽  
Lena Serghides ◽  
Marc Dryer
Keyword(s):  
Patient Education ◽  
Hiv Transmission ◽  
Healthcare Providers ◽  
Culturally Sensitive ◽  
Target Audience ◽  
Transmission Risk ◽  
User Testing ◽  
Living With Hiv ◽  
Direct Feedback ◽  
Mother To Child

This thesis project uses animation to communicate the risk of HIV transmission via breastfeeding to mothers living with HIV in Canada. Current guidelines do not recommend breastfeeding for HIV+ mothers because there is always some level of risk. Knowledge of mother-to-child transmission is poor, and the cultural pressure to breastfeed has complex implications. It was essential that the science of transmission risk be conveyed in a clear and culturally sensitive manner, to allow women to make appropriate, informed decisions about whether or not to breastfeed. To accomplish this, we adopted a user-testing approach. Throughout development, the script, animatic, and character designs were presented for feedback to members of the target audience, healthcare providers, and representatives from Canadian HIV organizations in an iterative design process. At each round of feedback, the script, animatic, and visual assets were revised, and sent for further comment. Ongoing collaboration with the target audience helped us develop an animation with a wide diversity of characters, culturally sensitive metaphors, and nuanced descriptions of risk, in response to feedback that detailed desires about representation and identified how concepts were being misunderstood. User-testing approaches are necessary when creating patient education animations. Population needs, background, and context have a dramatic impact on patient understanding, and cannot be understood properly without user testing and direct feedback. Doing so helps prevent insensitive concepts and easily misinterpreted information, and thus is key to effective patient education animation.

scholarly journals Deep Vein Thrombosis in Adults-A Review

2021 ◽  
pp. 130-134
Author(s):  
Monali Walke ◽  
Savita Pohekar
Keyword(s):  
Blood Clot ◽  
Hormonal Treatment ◽  
Signs And Symptoms ◽  
Pharmacological Therapy ◽  
The Body ◽  
Self Assessment ◽  
Vein Thrombosis ◽  
Common Sign ◽  
Deep Vein ◽  
First Time

DVT is a type of blood clot that occurs in the deep veins of the leg or pelvis. An embolus occurs when a thrombus, or blood clot, breaks off. Emboli can go to the lungs and cause a PE. DVT is the most found reason for maternal death in developing country, according to a 2017 analysis. In children, DVT is relatively uncommon. According to a 2016 report, DVT affects 0.30 out of every 100,000 children under the age of nine and 0.64 out of every 100,000 children between the ages of ten and nineteen. Throughout high-income nations, roughly 1.5 out of 1000 adults will get VTE for the first time each year, 5–11 percent of persons will have VTE  their lifetime. As people get older, VTE becomes significantly more common. DVT has several risk factors, some of which are listed here. An injury to your veins, such as a bone fracture, Being overweight puts extra pressure on your legs and pelvis veins. Having a DVT family history, A catheter is put into a vein, Female who is taking hormonal treatment or pills of birth control. A common sign is edema in your foot, ankle, or leg, mostly one side. Cramping pain in the affected leg that usually starts in the calf Area of skin that is noticeably warmer than the rest of the body. Diagnosis of DVT includes Ultrasound, Venogram, d-dimer test. Medical Management of DVT pharmacological therapy i.e. unfractional heparin, low molecular heparin, anticoagulant, thrombolytic therapy used. Conclusion : Awareness and understanding its signs and symptoms are more effective and less expensive than the secondary prevention. Encouragement and education for the self-reporting and self-assessment help to the early detection and prevention of DVT.

scholarly journals Human Immunodeficiency Virus Infection in Pregnancy

1998 ◽  
Vol 9 (5) ◽  
pp. 301-309
Author(s):  
Yasemin Arikan ◽  
David R Burdge
Keyword(s):  
Human Immunodeficiency Virus ◽  
Vertical Transmission ◽  
Hiv Transmission ◽  
Well Being ◽  
Current Evidence ◽  
Future Health ◽  
Child Bearing ◽  
Immunodeficiency Virus ◽  
Vertical Transmission Of Hiv ◽  
In Pregnancy

The incidence and prevalence of human immunodeficiency virus (HIV) infection in women of child-bearing age continue to increase both internationally and in Canada. The care of HIV-infected pregnant women is complex, and multiple issues must be addressed, including the current and future health of the woman, minimization of the risk of maternal-infant HIV transmission, and maintenance of the well-being of the fetus and neonate. Vertical transmission of HIV can occur in utero, intrapartum and postpartum, but current evidence suggests that the majority of transmission occurs toward end of term, or during labour and delivery. Several maternal and obstetrical factors influence transmission rates, which can be reduced by optimal medical and obstetrical care. Zidovudine therapy has been demonstrated to reduce maternal-infant transmission significantly, but several issues, including the short and long term safety of antiretrovirals and the optimal use of combination antiretroviral therapy in pregnancy, remain to be defined. It is essential that health care workers providing care to these women fully understand the natural history of HIV disease in pregnancy, the factors that affect vertical transmission and the management issues during pregnancy. Close collaboration among a multidisciplinary team of knowledgeable health professionals and, most importantly, the woman herself can improve both maternal and infant outcomes.

scholarly journals Vertical Transmission of HIV-1 in the Metropolitan Area of Belo Horizonte, Brazil: 2006–2014

2017 ◽  
Vol 40 (02) ◽  
pp. 059-065 ◽  
Author(s):  
Victor Melo ◽  
Marcelle Maia ◽  
Mário Correa Júnior ◽  
Fabiana Kakehasi ◽  
Flávia Ferreira ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Metropolitan Area ◽  
Research Group ◽  
Highly Active Antiretroviral Therapy ◽  
National Guidelines ◽  
Highly Active ◽  
Vertical Transmission Of Hiv ◽  
Belo Horizonte ◽  
Mother To Child ◽  
Hiv 1

Objective To revise HIV-1 vertical transmission (VT) rates in the metropolitan area of Belo Horizonte, Brazil, from January of 2006 to December of 2014. Methods Descriptive study of a prospective cohort of HIV-1-infected pregnant women and their children, monitored by the Maternal and Child HIV/Aids Research Group of Research Group at Faculty of Medicine of Universidade Federal de Minas Gerais, Brazil. Results The VT general rate was 1.9% (13/673; confidence interval [CI] 95%: 1.0–3.3). The extensive use of combined highly active antiretroviral therapy (HAART) (89.7%; 583/650) strongly impacted the reduction of VT during this period. Maternal viral load (VL) higher than 1,000 copies/mL showed significant association with VT (OR:6.6; CI 95%:1.3–33.3). Maternal breastfeeding was described in 10 cases in this cohort (1.5%; CI 95%: 0.7–2.7), but it was not associated with VT. Conclusion The present cohort data were coherent with the low VT rate described in other global populations, and it was considerably lower in comparison to the results of the same cohort during the period of 1998–2005, when the VT rate was 6.2%. These data confirm the efficiency of the National Guidelines, and emphasize the importance of adopting the international recommended procedures for prevention of mother-to-child transmission (MTCT) of HIV.

scholarly journals Lack of HIV RNA test result is a barrier to breastfeeding among women living with HIV in Botswana

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gloria Katuta Mayondi ◽  
Aamirah Mussa ◽  
Rebecca Zash ◽  
Sikhulile Moyo ◽  
Arielle Issacson ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Hiv Transmission ◽  
Healthcare Providers ◽  
Feeding Method ◽  
Hiv Rna ◽  
Women Living With Hiv ◽  
Feeding Choice ◽  
Infant Feeding Decisions ◽  
Living With Hiv ◽  
Mother To Child

Abstract Background Botswana updated its antiretroviral treatment (ART) guidelines in May 2016 to support breastfeeding for women living with HIV (WLHIV) on ART who have documented HIV RNA suppression during pregnancy. Methods From September 2016 to March 2019, we evaluated feeding method at discharge among WLHIV at eight government maternity wards in Botswana within the Tsepamo Study. We validated the recorded feeding method on the obstetric record using the prevention of mother-to-child transmission of HIV (PMTCT) counsellor report, infant formula dispensing log or through direct observation. Available HIV RNA results were recorded from the obstetric record, and from outpatient HIV records (starting February 2018). In a subset of participants, we used electronic laboratory records to verify whether an HIV RNA test had occurred. Univariable and multivariable logistic regression analyses were performed to identify factors associated with infant feeding choice. Results Among 13,354 WLHIV who had a validated feeding method at discharge, 5303 (39.7%) chose to breastfeed and 8051 (60.3%) chose to formula feed. Women who had a documented HIV RNA result in the obstetric record available to healthcare providers at delivery were more likely to breastfeed (50.8%) compared to women who did not have a documented HIV RNA result (35.4%) (aOR 0.59; 95% CI 0.54, 0.65). Among women with documented HIV RNA, 2711 (94.6%) were virally suppressed (< 400 copies/mL). Breastfeeding occurred in a substantial proportion of women who did not meet criteria, including 46 (30.1%) of 153 women with HIV RNA > 400 copies/mL, and 134 (27.4%) of 489 women with no reported ART use. A sub-analysis of electronic laboratory records among 150 women without a recorded result on the obstetric record revealed that 93 (62%) women had an HIV RNA test during pregnancy. Conclusions In a setting of long-standing use of suppressive ART, with majority of WLHIV on ART from the time of conception, requiring documentation of HIV RNA suppression in the obstetric record to inform infant feeding decisions is a barrier to breastfeeding but unlikely to prevent a substantial amount of HIV transmission.

scholarly journals Mother-to-Child HIV Transmission among Infants Born to HIV-Positive Women in Amhara National Regional State, Ethiopia

2020 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Zebideru Z Abebe ◽  
Mezgebu Y Mengistu ◽  
Yigzaw K Gete ◽  
Abebaw G Worku ◽  
◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Clinical Stage ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Significance Level ◽  
Hiv Test ◽  
Mtct Rate ◽  
Vertical Transmission Of Hiv ◽  
Mother To Child

Mother-to-child transmission (MTCT) is the major source of HIV infection among children under the age of 15 years. There were limited studies on the MTCT rate in Amhara Region, Ethiopia. Therefore, this study aimed to measure mother-to-child transmission and to identify factors associated with MTCT. An institutional-based retrospective cohort study was conducted among HIV-exposed infants (HEIs). The HEIs who booked in mother–baby pair cohort register between January 2014 and December 2016 were abstracted and included in the study. A structured pretested questionnaire was used for data abstraction. The collected data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. A penalized logistic regression model was used. p-value <0.05 was taken as the significance level. A total of 796 HEIs participated in the study in which 96.9% received nevirapine prophylaxis, 97.5% were exclusively breastfed for 6 months, and 95.2% received HIV test at 6 weeks. About 36.5% of mothers of HEIs received ART (Antiretroviral Treatment) for less than 4 weeks during delivery. Of the mothers of HEIs, 7.6% were in WHO clinical stage I and 64.1% had >350 CD4 count at the first antenatal care visit. Overall, MTCT of HIV was 1.5%, and 59.2% of HEIs were discharged from the PMTCT care at the age of 12-18 months. The vertical transmission of HIV was significantly associated with the duration of ART (AOR 0.16; 95% CI: 0.02, 0.96). The MTCT was 84.0% less likely in mothers who did receive Antiretrovirals (ARVs) >12 months compared with mothers who did receive ARVs <4 weeks during delivery. The study indicated that vertical transmission of HIV was significantly associated with the duration of ART. Even if a considerable low MTCT rate was observed, early identification and treatment among HIV-positive pregnant women should be strengthened.

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