scholarly journals Anaemia in HIV positive mothers on antiretroviral therapy for prevention of mother-to-child transmission HIV in a tertiary health institution in North Central Nigeria

Author(s):  
Nathaniel D. Adewole ◽  
Adaora A. Okechukwu ◽  
Richard A. Offiong ◽  
Francis O. Adebayo ◽  
Dennis A. Isah ◽  
...  

Background: Anaemia in pregnancy and HIV infection are two common public health issues in sub-Saharan African with Nigeria bearing the greatest burden. The duo occurring together poses a higher risk of morbidity and mortality for both the foetus and the mother. We therefore conducted this study to determine the burden of anaemia and other haematological abnormalities among HIV positive pregnant mothers on antiretroviral therapy who attended antenatal clinical services in our health institution.Methods: A 10-year retrospective review from January 2010 to December 2019 of medical records of HIV positive mothers on highly anti-retroviral therapy in attendance for antenatal clinical services in our health institution was carried out for the above objectives. Information extracted were, age, HIV status, gestational age at delivery, type of antiretroviral drugs used, duration of use, haemoglobin level, platelet, and complete blood count at booking of the positive mothers.Results: Of a total of 330 HIV positive mothers seen during the review period, 82.7% were from rural communities, 88.8% were from middle socio-economic class, 80.0% were Christians, and 80.3% started their highly active antiretroviral therapy before their index pregnancy. Most, 51.5% and 42.7% were on zidovudine, lamivudine and nevirapine, and tenofovir with lamivudine and lopinavir boasted ritonavir combinations, while 94.2% were on 1st line antiretroviral medication. Their mean age, gestational age at delivery, and parity were 31.11±4.7 years, 38.57±3.1 weeks, and 2.0±1.6 respectively. The prevalence of anaemia, thrombocytopenia and leucopoenia were 36.1%, 4.8%, and 6.7% respectively while their mean CD4 cell count and viral loads at the point of booking were 543.63±283.7 cells/μl, and 2953.02±1619.9 copies/ml. The two maternal variables that showed significant relationship with haemoglobin concentration of <10 gm/dl was mother’s level of education x2=6.29, p=0.043, and her socio=economic class, x2=10.162, p=0.006.Conclusions: There is high burden of anaemia among HIV positive mothers on antiretroviral therapy in our environment. The prevalence of thrombocytopenia and leucopoenia was much lower. The burden of maternal anaemia was associated with maternal level of education and her socio-economic class.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Betty Mogesi Samburu ◽  
Judith Kimiywe ◽  
Sera Lewise Young ◽  
Frederick Murunga Wekesah ◽  
Milka Njeri Wanjohi ◽  
...  

Abstract Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers. Methods Qualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis. Results Facilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity. Conclusions There are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.


Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 578
Author(s):  
Win-Long Lu ◽  
Yuan-Ti Lee ◽  
Gwo-Tarng Sheu

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.


2011 ◽  
Vol 57 (1) ◽  
pp. 76-85 ◽  
Author(s):  
Steven E. Lipshultz ◽  
William T. Shearer ◽  
Bruce Thompson ◽  
Kenneth C. Rich ◽  
Irene Cheng ◽  
...  

Author(s):  
Fiekumo Igbida Buseri ◽  
Evelyn Mgbeoma Eze ◽  
Ngowari Golden

Background: Pregnancy associated with human immunodeficiency virus (HIV)- infection poses risk to the fetus due to vertical-transmission. This can be prevented through administration of antiretroviral drugs. Our objective was to investigate the incidence of vertical-transmission of HIV and its correlation with maternal gestational age at antenatal booking with immediate commencement of antiretroviral therapy in Port-Harcourt, Nigeria. Methods: All antenatal attendees and their HIV-exposed newborns were screened for HIV-infection between April, 2016 and May, 2017 using qualitative rapid ELISA kits and HIV-DNA PCR technique. The HIV-positive antenatal attendees were placed on daily single-dose triple antiretroviral regimen (efavirenz, lamivudine, tenofovir, 600/300/300mg tablet) with multivitamins from the first day of booking and continued afterward. The HIV-exposed babies were placed on 5ml daily single-dose triple antiretroviral chemoprophylaxis on the first day of delivery and continued until blood collection at 6 weeks for HIV diagnosis. Statistical Package for Social Science (SPSS) software (version 17.0) was used for data analysis. Results: We found 4.34% overall prevalence of HIV-1 infection among the antenatal attendees and 7.57% incidence of mother-to-child transmission. There was significant difference between gestational age at booking with commencement of ART and the number of HIV-positive babies (χ2=7.113, df=2, P<0.05). There was no vertical transmission among the attendees who booked at first trimester, 35.7% at second trimester and 64.3% at third trimester. There was no statistically significant gender difference (P>0.05) between the number of infected males, 42.9% and females, 57.1%. Conclusion: High incidence of vertical-transmission of HIV was obtained from those HIV-positive mothers who registered late for antenatal care. Therefore, strong advocacy for early entry into antenatal care is solicited.


2020 ◽  
Vol 6 (4) ◽  
pp. 93-97
Author(s):  
Anyanwu Matthew

Background:/Aims: The use of antiretroviral drugs (ARVs) in pregnancy has shown remarkable improvement in immune status and have revolutionized the approach of care to people living with HIV (PLHIV). Some adverse pregnancy conditions have been reported which may depend on type of regimen, time and duration of use. The use of ARVs in pregnancy have been dynamic and transition from one regimen to the other have setting and country based variations. Therefore, knowing the impact of ARVs in pregnancy among PLHIV in our settings deserve evidence based information. Methods: Pregnant women attending antenatal clinic at the hospital were prospectively recruited and followed up. HIV positive mothers were recruited irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computer database. Mothers and their children were followed until 6 weeks postpartum. The data was analyzed with Epi-info version 7.1.5. Chi square at significant level of 0.05 and confidence level of 95% was used to determine significance. Results: A total of 55 HIV positive mothers were in the study. The age range was between 18 to 45 years and parity was 0 to 8. The mean birth weight and gestation age at delivery was 2.92kg (SD 0.556) and 36 weeks (SD 2.8 weeks) respectively. The absolute CD4 count of 500cells/mm3 and above (43.3%) was associated with no low birth weight. The mean glycaemic results were within normal range, 4.02-4.75 and 5.00-6.79 Mmol/l pre and post prandial respectively. Conclusion: Low birth weight was not associated with HAART in pregnancy and good immune condition was not associated with low birth weight. There was no association of protease inhibitors and gestational diabetes mellitus.


2020 ◽  
Author(s):  
Matthew Anyanwu ◽  
Sam Anya ◽  
Richard Offiong ◽  
Bissallah Ekele

Abstract BackgroundAims: The use of HAART in pregnancy has shown remarkable improvement in immune status and have revolutionized the approach of care to people living with HIV. Some adverse pregnancy conditions have been reported which may depend on type of regimen, time and duration of use. The use of ARVs in pregnancy have been dynamic and transition from one regimen to the other have setting and country based variations. Therefore, knowing the impact of ARVs in pregnancy among PLHIV in our settings deserve evidence based information.MethodsPregnant women attending antenatal clinic at the hospital were prospectively recruited and followed up. HIV positive mothers were recruited irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computer database. Mothers and their children were followed until 6 weeks postpartum. The data was analyzed with Epi-info version 7.1.5. Chi square at significant level of 0.05 and confidence level of 95% was used to determine significance.ResultsA total of 55 HIV positive mothers were in the study. The age range was between 18 to 45 years and parity was 0 to 8. The mean birth weight and gestation age at delivery was 2.92 kg (SD 0.556) and 36 weeks (SD 2.8 weeks) respectively. The absolute CD4 count of 350cells/mm3 and above (57.13%) was associated with low incidence of low birth weight. The mean glycaemic results were within normal range, 4.02–4.75 and 5.00-6.79 Mmol/l pre and post prandial respectively.Conclusionlow birth weight was not associated with HAART in pregnancy and good immune condition was not associated any low birth weight. There was no association of protease inhibitors and gestational diabetes mellitus


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261581
Author(s):  
Alex Yeshaneh ◽  
Adugna Lencha ◽  
Amlaku Mulat Aweke ◽  
Yaregal Dessalew ◽  
Tegegne Wale ◽  
...  

Background Human immunodeficiency virus (HIV) affects a highly significant number of people and is responsible for the deaths of many people in sub-Saharan African countries alone. The best prevention method for this virus is through consistent condom utilization which can help to prevent drug-resistant HIV infection and acquisition of new infection. Therefore, this study aimed to assess consistent condom utilization and associated factors among HIV-positive individuals attending an antiretroviral therapy clinic at Pawi general hospital, North West Ethiopia in 2020. Methods An institutional based cross-sectional study was conducted among 419 HIV-positive individuals who have follow-up in the Pawi general hospital antiretroviral therapy clinics, from January to February 2020. The study subjects were reached using a systematic sampling technique and data were collected using a pretested and structured questionnaire. Data entry and analysis were performed using epi-data version 3.1 and SPSS version 23 respectively. Binary and multivariable analyses with a 95% confidence level were performed. In the final model, variables with P < 0.05 were considered statistically significant. Results A total of 419 antiretroviral therapy study participants were participated in the study with a response rate of 100%. In this finding, the consistent condom utilization rate was 49.2% [95% CI: 42.2–56.5%]. After controlling for possible confounding factors, the results showed that place of residence [AOR = 2.16, 95% CI: 1.05, 4.45], marital status [AOR = 0.19, 95%CI: 0.05, 0.67], number of partners [AOR = 0.19, 95% CI: 0.07, 0.55] and level of education [AOR = 5.33, 95% CI: 1.57, 18.08] were associated factors of consistent condom utilization. Conclusion Consistent condom utilization among HIV-positive clients attending antiretroviral therapy clinics at Pawi general hospital was low. Residence, marital status, level of education and number of partners were significantly associated factors of consistent condom use. Health education program and counseling services should be started to increase knowledge about way of transmission and appropriate use of condoms, increase self-efficacy towards condom use and reduction in the number of sexual partners.


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