scholarly journals From Undetectable Equals Untransmittable (U=U) to Breastfeeding: Is the Jump Short?

2021 ◽  
Author(s):  
Tullio Prestileo ◽  
Adriana Sanfilippo ◽  
Lorenza Di Marco ◽  
Antonina Argo
Keyword(s):  
Retrospective Study ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Antiretroviral Treatment ◽  
Treatment Guidelines ◽  
Scientific Evidence ◽  
Hiv Rna ◽  
Vertical Transmission Of Hiv ◽  
Small Cohort ◽  
Prophylaxis Therapy

Background: Vertical transmission of HIV infection can occur during pregnancy, during childbirth or through breastfeeding. The recommendations issued by the various international guidelines (WHO 2010, EACS 2017, DHHS 2017) on the safety of breastfeeding of HIV-infected women in effective antiretroviral treatment do not provide univocal indications referring to individual countries the choice to advise or advise against such procedure. Methods: A retrospective study was conducted in a small cohort of HIV-infected pregnant women who, despite the information received, decided to breastfeed their children. The observation was carried out in the period between March 2017 and June 2021. In all newborns, prophylaxis therapy was initiated at birth, according to the treatment guidelines, the scheme adopted involved the administration of zidovudine (AZT) orally for 4 weeks, started immediately after the childbirth. Breastfeeding time was, on average, 5 months. Results: No contagion was diagnosed. All infants were tested for HIV-RNA at birth, 1, 3, and 6 months after birth, and 1, 3 and 3 months after stopping breastfeeding. Conclusions: The data obtained represent, in our opinion, a solicitation to discuss and re-evaluate scientific evidence that starting from "Undetectable Equals Untransmittable" (U = U) can open a scientific and cultural review of breastfeeding.

scholarly journals Factors associated with time to achieve an undetectable HIV RNA viral load after start of antiretroviral treatment in HIV-1-infected pregnant women

2017 ◽  
Vol 3 (1) ◽  
pp. 34-39 ◽  
Author(s):  
W. Snippenburg ◽  
F.J.B. Nellen ◽  
C. Smit ◽  
A.M.J. Wensing ◽  
M.H. Godfried ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Antiretroviral Treatment ◽  
Factors Associated ◽  
Hiv Rna ◽  
Hiv 1

scholarly journals Rapid HIV RNA rebound after antiretroviral treatment interruption in persons durably suppressed in Fiebig I acute HIV infection

2018 ◽  
Vol 24 (7) ◽  
pp. 923-926 ◽  
Author(s):  
Donn J. Colby ◽  
◽  
Lydie Trautmann ◽  
Suteeraporn Pinyakorn ◽  
Louise Leyre ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Antiretroviral Treatment ◽  
Treatment Interruption ◽  
Acute Hiv Infection ◽  
Hiv Rna ◽  
Acute Hiv

scholarly journals CYTOMEGALOVIRUS INFECTION IN PREGNANT WOMEN WITH HIV INFECTION

2018 ◽  
Vol 10 (3) ◽  
pp. 40-47 ◽  
Author(s):  
L. I. Zhukova ◽  
Yu. G. Shakhverdyan
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Cytomegalovirus Infection ◽  
Comparison Group ◽  
Well Being ◽  
Infection Frequency ◽  
Cmv Infection ◽  
Hiv Rna ◽  
Clinical Forms ◽  
Women With Hiv

Purpose: еstablishment of the frequency of infection and clinical forms of cytomegalovirus infection in pregnant women with HIV infection. Materials and methods. A retrospective analysis of medical records of 254 HIV-infected pregnant women of the Krasnodar Territory was conducted, which were observed in the framework of the current regulations on HIV infection and the management of pregnant women. Verification of cytomegalovirus infection and distribution of clinical forms was carried out by serological tests. The comparison group is a prospective analysis of 29 pregnant women with HIV infection who were additionally examined for cytomegalovirus infection by polymerase chain reaction. Results. Latent form of CMV infection was diagnosed in 220 (90,5%) of HIV-infected pregnant women, primary — in 5 (2,1%) and reactivated (late primary, reinfection)— in 18 (7,4%). Cytomegalovirus infection frequency increase with growing pregnant, increasing stages of HIV infection, more frequent multiplicity pregnancy, reducing CD4+ T-lymphocytes and increase in HIV RNA. The well-being of obstetric history had no effect on the incidence of infection with cytomegalovirus and various forms of CMV infection. Reactivated forms of cytomegalovirus infection were significantly more frequent in pregnant women with HIV infection at the lowest CD4 + T-lymphocyte counts, maximal HIV viremia, later onset of perinatal antiretroviral prophylaxis, but did not depend on the well-being of the obstetric anamnesis. A comparison group study demonstrated the presence of latent cytomegalovirus infection in all pregnant women, confirmed by the detection of only specific IgG. From the whole blood, the DNA of CMV in low concentration was isolated by PCR method in 1 (3,4%) of the patient, from the cervix — in 8 (27,6%). The amount of detected CMV DNA in the cervix was different, had a direct correlation with the level of HIV RNA of pregnant women and did not depend on the number of CD4-lymphocytes. The calculation of the relative risk in our observations demonstrated that the presence of cytomegalovirus in the cervix did not increase the risk of premature termination of pregnancy.

scholarly journals A case report A Nigerian adolescent with Long term Non-progressive HIV-infection: A case report

2020 ◽  
Vol 6 (2) ◽  
pp. 239-245
Author(s):  
MM Ogundeyi ◽  
OO Oba-Daini ◽  
UP Adeniyi ◽  
BI Adenuga
Keyword(s):  
Case Report ◽  
Hiv Infection ◽  
Severe Anaemia ◽  
Cd4 Count ◽  
Small Subset ◽  
Hiv Rna ◽  
Highly Active ◽  
Vertical Transmission Of Hiv ◽  
History Of

Children infected with the Human Immunodeficiency Virus (HIV) can be rapid progressors or be at the end of the spectrum of the illness as Long-term Non-progressors (LTNPs). Long term non-progressors are patients who never received Highly Active Anti-Retroviral Therapy (HAART) during the first decade of life and are maintaining good CD4+ count associated with declining HIV RNA values. The literature on paediatric patients with LTNP infection is sparse. An adolescent with HIV LTNP and likely vertical transmission of HIV is presented in this report. She presented with chronic cough, severe anaemia and dyspnea. She was wasted with bodyweight less than the 5th centile for age. She was not sexually active and had no history of blood transfusion, scarification, incisions or sharing of sharp grooming objects. The results of investigations suggested pulmonary tuberculosis and HIV infection. Her CD4 count was 42%. She was commenced on HAART and subsequently, anti-tuberculosis medications according to NTBLCP/DOTS Programme with improvement in symptoms and appreciable weight gain. Therefore routine voluntary HIV testing is recommended for all paediatric admission after consent or assent is obtained bearing in mind that a small subset of patients may fall into the LTNPs population.

scholarly journals HIV INFECTION AMONG PREGNANT WOMEN IN THE REPUBLIC OF BASHKORTOSTAN

2019 ◽  
Vol 11 (1) ◽  
pp. 46-52
Author(s):  
A. B. Latypov ◽  
D. A. Valishin ◽  
R. G. Yаpparov
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Hiv Infections ◽  
Specific Weight ◽  
Age Group ◽  
Republic Of Bashkortostan ◽  
Vertical Transmission Of Hiv ◽  
The Republic ◽  
And Control

The aim of this study was to characterize the situation of HIV infection among pregnant women in the Republic of Bashkortostan in 2013-2017 on the basis of a comprehensive retrospective analysis of indicators.A comprehensive retrospective analysis of statistical data on 2734 cases of pregnancies of HIV-infected women who were on dispensary observation at the Republican center for prevention and control of AIDS and infectious diseases in the period from 2013 to 2017 was carried out. The prevalence of HIV infection in pregnant women during the study period tended to increase annually from 656.4 to 857.8 per 100 thousand pregnancies. The prevalence of HIV infection among pregnant women who have completed pregnancy by childbirth increased from 650.7 to 795.0 per 100 thousand women who gave birth. The incidence of HIV infection among pregnant women, reflecting the first identified cases, increased from 248.4 to 267.1 per 100 thousand pregnancies. The proportion of newly diagnosed HIV infections among pregnant women in the structure of the overall HIV incidence has decreased from 7.92% to 6.03%. The main route of HIV infection of pregnant women was sexual, the average for the period of its specific weight was 92.6±4.0%, the parenteral pathway accounted for 7.4±4.0%. There is a steady change in the age structure of HIV-infected pregnant women with first time established diagnosis, towards the age group of 21-30 years. If in 2013, the structure was dominated by pregnant women aged 31-40 years (60.2%), in 2017 the first place was the age group of 21-30 years (47.9%). On average, 24.7±2.3% of HIV-infected women were admitted to the study period under observation up to 12 weeks of pregnancy. The rate of vertical transmission of HIV infection averaged 2.9±1.0% over the period. Determination of the main trends of HIV infection among pregnant women, allows to assess the effectiveness of the implemented therapeutic and preventive measures, to develop and implement new methods of organization of medical care of this category of population, aimed at reducing the spread of the disease.

scholarly journals Terapia antirretroviral em gestantes portadoras do HIV

2021 ◽  
Vol 3 (4) ◽  
pp. 2709-2716
Author(s):  
Sebastião Junior Henrique Duarte
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Antiretroviral Treatment ◽  
Inclusion Criteria ◽  
Medical Graduates ◽  
Antiretroviral Therapies ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Review Study ◽  
Terapia Antirretroviral

Este estudo de revisão integrativa da literatura teve como objetivo revisar as evidências descritas em protocolos assistenciais às gestantes com HIV quanto ao tratamento com antirretroviral. Teve-se por questão norteadora: como são usadas as terapias antirretrovirais em gestantes? Os dados foram obtidos por meio de busca nas bases de dados LILACS e SCIELO, abrangendo o período de 2010 até 2016, nos idiomas português, inglês e espanhol. Identificou-se 17 artigos, dos quais seis atenderam aos critérios de inclusão adotados. Os resultados foram organizados em quadro. A caracterização revelou que a maioria dos autores são formados em medicina, realizaram estudo retrospectivo em bases de dados e 66,6% das publicações ocorreram no Brasil. Os resultados revelaram que o correto uso da terapia antirretrovital descrita em protocolo atualizado reduz o potencial de transmissão vertical e possibilita o nascimento de recém-nascidos sem o vírus da imunodeficiência adquirida.   ABSTRACT This integrative literature review study aimed to review the evidence described in care protocols for pregnant women with HIV regarding antiretroviral treatment. The guiding question was: How are antiretroviral therapies used in pregnant women? The data were obtained by searching the LILACS and SCIELO databases, covering the period from 2010 to 2016, in Portuguese, English and Spanish. Seventeen articles were identified, six of which met the inclusion criteria adopted. The results were organized in a table. The characterization revealed that most authors are medical graduates, conducted retrospective study in databases and 66.6% of publications occurred in Brazil. The results revealed that the correct use of antiretroviral therapy described in an updated protocol reduces the potential for vertical transmission and enables the birth of newborns without acquired immunodeficiency virus.

scholarly journals Study of mycoses diagnosed in patients living with HIV hospitalized in the infectious diseases department of the CHU YO of Ouagadougou

2021 ◽  
Vol 7 (1) ◽  
pp. 059-063
Author(s):  
Mamoudou Savadogo ◽  
Ismaël Diallo ◽  
K Apoline Sondo
Keyword(s):  
Retrospective Study ◽  
Sex Ratio ◽  
Infectious Diseases ◽  
Hiv Infection ◽  
General Condition ◽  
Lymphocyte Count ◽  
Antiretroviral Treatment ◽  
Cd4 Count ◽  
Hiv Patients ◽  
Living With Hiv

Objective: To study the mycoses in HIV patients hospitalized in the infectious diseases department of the CHU YO (Yalgado Ouédraogo) Patients and method: This was a retrospective study carried out in the SMIT of the CHU-YO over a period of ten years from January 1, 2010 to December 31, 2019. Results: During the study period 145 cases of mycosis were diagnosed in patients living with HIV. The average age of the patients was 42±11 years. The sex ratio was 0.64. On admission, the majority of patients (71.54%) had an impaired general condition. All patients were severely immunocompromised (mean CD4 count=59 cells/mm3). Digestive candidiasis and neuromeningeal cryptococcosis were the most frequently diagnosed mycoses. Other comorbidities were dominated by digestive coccidiosis (Cryptosporidiosis, Isosporosis) and common germ pneumonia. All patients had received antifungal and antiretroviral treatment. The evolution was marked by a lethality of 25%. Conclusion: The mycoses are relatively frequent and potentially serious during HIV infection. Their prognosis was even worse when the TCD4 lymphocyte count was low and when there were other associated comorbidities.

The Effect of Antiretroviral Therapy on IL-6, IL-1β, TNF-α, IFN-γ Levels and their Relationship with HIV-RNA and CD4+ T Cells in HIV Patients

2020 ◽  
Vol 18 (5) ◽  
pp. 354-361
Author(s):  
Gülay Okay ◽  
Meliha Meric Koc ◽  
Eray Metin Guler ◽  
Ayşegül Yabaci ◽  
Abdürrahim Kocyigit ◽  
...  
Keyword(s):  
T Cell ◽  
Hiv Infection ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Positive Correlation ◽  
Hiv Rna ◽  
Tnf Α ◽  
Cytokine Levels ◽  
Ifn Γ ◽  
Cd4 T Cell Count

Background: Serum cytokine levels over the course of HIV infection usually increase with immunosuppression and decrease after antiretroviral treatment (ART). Objectives: The aim of the study is to compare cytokine levels between HIV-infected patients (HIP) and controls and investigate the relationship between CD4+T cell count, HIV-RNA levels, and cytokine levels. Methods: The study subjects comprised ART-naive HIP (n=30) with no comorbidities and age-and sex-matched healthy controls. We measured levels of IL-6, IL-1β, TNF-α, and IFN-γ in serum samples of HIP at the beginning and at month 6 of ART and in controls. Results: The mean age of the study subjects was 38.7 ±10.3 years, with men making up 86.7% of the study subjects (n=26). IL-6, IL-1β, and TNF-α levels were significantly higher in both ART-naive (p<0.001, p=0.002, p=0.001) and ART-experienced HIP (p<0.001) than controls. The IFN-γ level was lower in both ART-naive and ART-experienced HIP compared to controls (p=0.082 and p=0.002). There was a positive correlation between the CD4+T cell count and serum concentration of IFN- γ(r=0.320, p<0.05). While the serum IFN-γ concentration showed a negative correlation with the HIVRNA level(r=-0.412, p<0.001), the serum IL-1β, IL-6, and TNF-α concentrations showed a positive correlation with the HIV-RNA level (r=0.349, p<0.001; r:0.54, p<0.001; r:0.438, p<0.00). Conclusions: Although serum concentrations of IL-6, IL-1β and TNF-α showed a significant decrease after ART, they were still significantly higher than the controls. IFN-γ responded differently to ART compared to the other cytokines, indicating that it may play a distinct and important role in the pathogenesis of HIV infection.

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