Failure of preventive measures leading to mother-to-child hiv transmission. Case report.

Infectio ro ◽  
2018 ◽  
Vol 56 (4) (1) ◽  
pp. 40-43
Author(s):  
Ruxandra Tritean ◽  
Simona Erscoiu ◽  
Andreia Florina Niță ◽  
Mircea Ioan Popa
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Perinatal Transmission ◽  
Immunological Parameters ◽  
Transmission Case ◽  
Prophylactic Measures ◽  
Hiv Infection Prevention ◽  
The Moment ◽  
Cmv Disease

Despite significant advances in antiretroviral treatment (ARV) and HIV infection prevention, about 400 children worldwide are still diagnosed daily with HIV infection, most cases due to perinatal transmission. It is estimated that the knowledge and rigorous application of prophylactic measures to reduce the vertical transmission of infection would significantly reduce this risk to less than 1%.  We report the case of a 5 months old infant coming from a pregnancy with HIV risk and multiple risk factors for transmission of the vertical infection, who did not receive postnatal testing and treatment. The diagnosis was established during infancy, falling into the AIDS stage by cytomegalovirus (CMV) disease with retinal sequelae occlusion. ARV treatment was initiated late, but from the moment of diagnosis, requiring further changes due to drug interactions, lack of availability and resistance to TARV. Although the patient’s progression was marked by severe comorbidities: sequelae of CMV disease, mixed HIV and CMV encephalopathy, pulmonary tuberculosis, repetitive respiratory and digestive opportunistic infections, the evolution of immunological parameters was slowly favorable under treatment. Proper implementation of prophylactic measures in the newborn and the pregnant woman could have significantly reduced the risk of HIV transmission to the patient, with a high probability that she would not have been infected. The case reported reflects the failure of strategies to prevent HIV / AIDS infection in pregnant women and newborns; conclusions must be drawn to avoid similar situations.

Syphilis and HIV Infection among Displaced Pregnant Women in Rural Mozambique

1994 ◽  
Vol 5 (2) ◽  
pp. 117-123 ◽  
Author(s):  
H A Cossa ◽  
S Gloyd ◽  
R G Vaz ◽  
E Folgosa ◽  
E Simbine ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Perinatal Transmission ◽  
Anal Intercourse ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hiv Seroprevalence ◽  
High Prevalence ◽  
History Of

A cross-sectional study was conducted among displaced pregnant women in Mozambique to determine the prevalence and correlates of HIV infection and syphilis. Between September 1992 and February 1993, 1728 consecutive antenatal attendees of 14 rural clinics in Zambézia were interviewed, examined, and tested for HIV and syphilis antibodies. The seroprevalence of syphilis and HIV were 12.2% and 2.9%, respectively. Reported sexual abuse was frequent (8.4%) but sex for money was uncommon. A positive MHA-TP result was significantly associated with unmarried status, history of past STD, HIV infection, and current genital ulcers, vaginal discharge, or genital warts. Significant correlates of HIV seropositivity included anal intercourse, history of past STD, and syphilis. In summary, displaced pregnant women had a high prevalence of syphilis but a relatively low HIV seroprevalence suggesting recent introduction of HIV infection in this area or slow spread of the epidemic. A syphilils screening and treatment programme is warranted to prevent perinatal transmission and to reduce the incidence of chancres as a cofactor for HIV transmission.

HIV Infection, AIDS and Vaccines

2021 ◽  
Author(s):  
Khrystyna Hrynkevych ◽  
Heinz-J. Schmitt
Keyword(s):  
Immune System ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Sexual Transmission ◽  
Hiv Infections ◽  
Perinatal Transmission ◽  
Human Immune System ◽  
Acute Hiv Infection ◽  
Acquired Immunodeficiency

HIV (human immunodeficiency virus) is a retrovirus that infects CD4+ T cells of the human immune system. If the infection is not treated, these cells are destroyed, resulting in an acquired immunodeficiency, i.e., “AIDS” (acquired immunodeficiency syndrome). HIV owns a reverse transcriptase enzyme to convert its RNA into DNA, which is then integrated into the human genome – then undetectable by the immune system. Today, sexual transmission is the major route of HIV infection, while parenteral transmission (sharing needles among drug addicts; rarely blood transfusion) and perinatal transmission are also possible. Acute HIV infection is accompanied by infectious mononucleosis-like symptoms (fevers, rash, lymphadenopathy, sore throat, fatigue), followed by a chronic asymptomatic stage, with viral replication at low levels, followed years later by AIDS, characterized by a plethora of possible opportunistic infections and cancers that result from T-cell deficiency and finally in death within about 2–3 years. Antiretroviral treatment (ART) includes 6 main classes of medicines that affect different steps of viral activities. While no cure is possible, ART – and particularly “Highly active antiretroviral therapy” (HAART) – has made HIV infections a chronic disease and therapy also results in a reduction of transmission. A large variety of vaccine candidates have been assessed – including phase 3 studies – but for many reasons, none of them have been successful to date.

scholarly journals Immunopathogenetic significance of activation and apoptosis of immunocompetent cells in children with HIV infection

2020 ◽  
Vol 12 (4) ◽  
pp. 23-28
Author(s):  
V. B. Denisenko ◽  
E. M. Simovanyan
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Immunocompetent Cells ◽  
Cell Component ◽  
Immunological Parameters ◽  
Latent Stage ◽  
Associated Symptoms ◽  
Immunological Examination ◽  
Late Stages ◽  
Secondary Diseases

The purpose is to clarify the immunopathogenetic significance of immunocompetent cells activation and apoptosis in children with HIV-infection.Materials and methods. A clinical and immunological examination of 92 children aged 1 to 5 years old with HIVinfection in latent stage 3 (25), in the stage of secondary diseases 4A (21), 4B (22) and 4V (24) was conducted.Results. During the clinical examination, the consistent appearance of HIV-associated symptoms, opportunistic infections, and tumors was noted. Changes in the immune status included abnormalities in the T-cell component – a decrease in the number of CD4-, CD3-, increase of CD8-lymphocytes, inversion of the CD4/CD8 ratio, in the B-cell component – hyperimmunoglobulinemia, increase in the content of circulating immune complexes, in the part of innate immunity factors – a decrease in the intensity of the oxygen-dependent neutrophil metabolism and its reserve capabilities. Identified impaired positive activation of lymphocytes – a decrease in the number of CD25- and an increase in HLADR-cells. An increase in the expression of CD95-receptors on the lymphocyte membrane, an increase in the number of lymphocytes in the early (AnV) and late stages of apoptosis (AnV/Pr) was found. With the progression of HIV infection, there was a deepening of these shifts in immunological parameters, especially during the transition to the stage of secondary diseases 4V (AIDS).Conclusion. An immunological examination and correlation analysis showed that an important immunopathogenetic mechanism for reducing the number of CD4 lymphocytes in children with HIV infection is the activation of apoptosis involving the receptor and mitochondrial mechanisms. One of the reasons for the formation of depressed cellular immunity was the hyperactivation of immunocompetent cells. The findings provide a rationale for the timely prescription of antiretroviral therapy for children with HIV-infection, which will prevent hyperactivation and apoptosis of immune system cells. 

scholarly journals Update on Prevention of Mother-to-Child HIV Transmission

2004 ◽  
Vol 12 (3-4) ◽  
pp. 152-213
Author(s):  
Lynne M. Mofenson
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Standard Of Care ◽  
Perinatal Transmission ◽  
Developed Countries ◽  
Pediatric Hiv ◽  
The Us ◽  
The Impact

The pediatric HIV epidemic in the US and other more developed countries changed dramatically after February 1994, when the results of PACTG 076 demonstrated that a triple regimen of ZDV reduced the risk of perinatal transmission by nearly 70%. Incorporation of ZDV prophylaxis into clinical practice, together with increased prenatal HIV counseling and testing, rapidly resulted in a significant decline in perinatal transmission and a concomitant decrease in the number of reported pediatric AIDS cases in the US. Transmission rates of 3–6% have been reported in various cohort studies with ZDV prophylaxis alone, and of 1–2% when ZDV is combined with elective Cesarean delivery or when women are treated with highly active antiretroviral regimens that reduce maternal viral load to unquantifiable levels. Additionally, several short antiretroviral regimens, including those that require administration only during the intrapartum and early postpartum periods, have been shown to decrease perinatal transmission. These regimens provide effective intervention even for HIV-infected pregnant women who have not received antiretroviral therapy and are identified late in pregnancy or for the first time at delivery through rapid HIV testing.However, this success has been partially offset by increasing HIV infection rates among young women, high adolescent pregnancy rates among at-risk populations, continued failure to identify HIV infection during pregnancy and inadequate prenatal care among HIV-infected women, particularly those using drugs. Additionally, the impact of evolving patterns of antiretroviral drug resistance on efficacy of prophylaxis is not known. As combination antiretroviral therapy becomes the standard of care for pregnant women in developed countries, evaluation of their infants for short- or long-term adverse consequences of intrauterine antiretroviral exposure is also a priority. Finally, clinical trials have identified short-course antiretroviral prophylaxis regimens that are effective and safe in resource-poor countries; however, transmission of HIV via breast milk remains a concern.

“I’ve got HIV and I want to have a baby”

HIV ◽  
2020 ◽  
pp. 67-78
Author(s):  
Thana Khawcharoenporn ◽  
Beverly E. Sha
Keyword(s):  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Perinatal Transmission ◽  
Hiv Care ◽  
Virologic Suppression ◽  
Sexually Transmitted ◽  
Comprehensive Management ◽  
Art Initiation ◽  
Effective Combination ◽  
Intrapartum Management

Perinatal transmission is one of the important routes of HIV transmission that is preventable in the era of effective combination antiretroviral therapy (ART). This chapter presents the case of a known HIV-infected, ART-naïve pregnant woman who establishes antenatal and HIV care late, at 32 weeks’ gestational age. Her presentation raises concerns about the potential risk of HIV transmission to her baby given limited time to achieve HIV virologic suppression. The appropriate management is discussed, which includes first-encounter screening, management of opportunistic infections and sexually transmitted infections, risk behavior modification and counseling, ART initiation and treatment monitoring, intrapartum management, infant prophylaxis, and postpartum HIV care. The case presentation and discussion highlight the importance of comprehensive management of HIV infection in pregnant women to minimize the risk of mother-to-infant HIV transmission and optimize HIV control in the mothers.

scholarly journals HIV Infection: What Should We Know?

2020 ◽  
Vol 2 (1) ◽  
pp. 01-16
Author(s):  
Ridwan Balatif
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Acquired Immunodeficiency ◽  
To Come ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Acquired Immunodeficiency Syndrome (AIDS) was first known in 1981 in homosexual groups who had opportunistic infections and malignancies. In Indonesia the first AIDS case was reported in 1987 to a Dutch citizen living in the province of Bali. Cases of HIV infection in Indonesia are reported to increase every year and most occur at the age of 25-49 years. HIV transmission is not easily transmitted, even when an HIV-infected person takes antiretroviral drugs can reduce the risk of transmission by up to 96%. But one of the biggest challenges in managing HIV infection is facing stigma and discrimination. As many as 1 in 5 people living with HIV are afraid to come to the clinic because they will experience discrimination and stigma from the community if this condition occurs will cause treatment delay until PLWHA (People living with HIV/AIDS) will fall to the AIDS stage and PLWHA will be susceptible to opportunistic infections. A clinic in Namibia, when stigma and discrimination were successfully overcome, there was a 20% reduction in mortality in PLWHA

A Qualitative Study Exploring Harmful Cultural Practices and HIV Stigma in North Central Nigeria

2020 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Bala Augustine Nalah ◽  
Azlinda Azman ◽  
Paramjit Singh Jamir Singh
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Cultural Practices ◽  
Qualitative Interviews ◽  
Well Being ◽  
Cultural Practice ◽  
Hiv Stigma ◽  
Hiv Positive ◽  
North Central ◽  
Harmful Cultural Practices

Harmful cultural practices have psychosocial implications on stigmatization and vulnerability to HIV infection among HIV positive living in North Central Nigeria. To understand this, we conducted qualitative interviews with purposively selected 20 diagnosed HIV positive to explore how culture influences stigmatization and HIV transmission. Data was collected using audio-recorder, transcribed, and analyzed through thematic analysis using ATLAS.ti8 software to code and analyze interview transcripts. The coded data were presented using thematic network analysis to visualize the theme, sub-themes, and quotations in a model. The findings reveal that lack of education was a significant determinant for the continual practice of harmful cultural rites, thereby increasing the risk of HIV infection and stigmatization. Hence, six cultural facilitators have been identified to include female genital mutilation, lack of education, tribal marks and scarification, postpartum sexual abstinence during breastfeeding, sexual intercourse during menstruation, and gender inequality, polygamy, and inheritance law. We conclude that educational teachings and advocacy campaigns be organized in rural schools and public places on the implications of harmful cultural practice to health and psychological well-being. We recommend that the social workers and behavioral scientists should collaborate with other agencies to employ a behavioral-based intervention in eliminating cultural practices and HIV stigma.

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.

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