scholarly journals Lactobacillus-Depleted Vaginal Microbiota in Pregnant Women Living With HIV-1 Infection Are Associated With Increased Local Inflammation and Preterm Birth

2021 ◽  
Vol 10 ◽  
Author(s):  
Charlotte-Eve S. Short ◽  
Richard G. Brown ◽  
Rachael Quinlan ◽  
Yun S. Lee ◽  
Ann Smith ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Vaginal Microbiota ◽  
Second Trimester ◽  
Local Inflammation ◽  
Women Living With Hiv ◽  
Gestational Age At Delivery ◽  
Living With Hiv ◽  
Hiv 1

BackgroundPregnant women living with HIV-1 infection (PWLWH) have an elevated risk of preterm birth (PTB) of unknown aetiology, which remains after successful suppression of HIV. Women at high risk for HIV have a common bacterial profile which has been associated with poor birth outcomes. We set out to explore factors associated with gestational age at delivery of PWLWH in a UK population.MethodsProspective study of PWLWH (n = 53) in whom the vaginal microbiota and cervicovaginal cytokine milieu were assessed using metataxonomics and multiplexed immunoassays, respectively. Cross-sectional characterisation of vaginal microbiota in PWLWH were compared with 22 HIV uninfected pregnant women (HUPW) at a similar second trimester timepoint. Within PWLWH the relationships between bacterial composition, inflammatory response, and gestational age at delivery were explored.FindingsThere was a high rate of PTB among PWLWH (12%). In the second trimester the vaginal microbiota was more diverse in PWLWH than in HUPW (Inverse Simpson Index, p = 0.0004 and Species Observed, p = 0.009). PWLWH had a lower prevalence of L. crispatus dominant vaginal microbiota group (VMB I, 15 vs 54%) than HUPW and higher prevalence of L. iners dominant (VMB III, 36 vs 9% and VMB IIIB, 15 vs 5%) and mixed anaerobes (VMB IV, 21 vs 0%). Across the second and third trimesters in PWLWH, VMB III/IIIB and IV were associated with PTB and with increased local inflammation [cervicovaginal fluid (CVF) cytokine concentrations in upper quartile]. High bacterial diversity and anaerobic bacterial abundance were also associated with CVF pro-inflammatory cytokines, most notably IL-1β.InterpretationThere is an association between local inflammation, vaginal dysbiosis and PTB in PWLWH. Understanding the potential of antiretroviral therapies to influence this cascade will be important to improve birth outcomes in this population.

Investigation of factors associated with spontaneous preterm birth in pregnant women living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (5) ◽  
pp. 719-727
Author(s):  
Arianne Y.K. Albert ◽  
Chelsea Elwood ◽  
Emily C. Wagner ◽  
Zahra Pakzad ◽  
Tessa Chaworth-Musters ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Spontaneous Preterm Birth ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals Epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in a region of Southern Brazil where the subtype C of HIV-1 infection predominates

2011 ◽  
Vol 15 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Sandra Aparecida Manenti ◽  
João Galato Júnior ◽  
Elizângela da Silva Silveira ◽  
Roberto Teixeira Oenning ◽  
Priscyla Waleska Targino de Azevedo Simões ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Southern Brazil ◽  
Subtype C ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Hiv Aids

scholarly journals Epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in a region of Southern Brazil where the subtype C of HIV-1 infection predominates

2011 ◽  
Vol 15 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Sandra Aparecida Manenti ◽  
João Galato Júnior ◽  
Elizângela da Silva Silveira ◽  
Roberto Teixeira Oenning ◽  
Priscyla Waleska Targino de Azevedo Simões ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Southern Brazil ◽  
Subtype C ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Hiv Aids

Prevalence and association with birth outcomes of low Vitamin D levels among pregnant women living with HIV

AIDS ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Anne Bergløv ◽  
Ellen Moseholm ◽  
Terese L. Katzenstein ◽  
Isik S. Johansen ◽  
Merete Storgaard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Women Living With Hiv ◽  
Vitamin D Levels ◽  
Living With Hiv

scholarly journals 885. Pregnancy Outcomes and Pharmacokinetics in Pregnant Women Living with HIV Exposed to Long-Acting Cabotegravir and Rilpivirine in Clinical Trials

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S534-S534
Author(s):  
Parul Patel ◽  
Susan L Ford ◽  
Mark Baker ◽  
Claudia Meyer ◽  
Louise Garside ◽  
...  
Keyword(s):  
Research And Development ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
Reproductive Potential ◽  
Compassionate Use ◽  
Live Births ◽  
Women Living With Hiv ◽  
Long Acting ◽  
Living With Hiv

Abstract Background Limited data exist among women living with HIV who become pregnant while exposed to long-acting (LA) cabotegravir (CAB) and rilpivirine (RPV). We report outcomes in pregnant participants and LA pharmacokinetic (PK) tail data in pregnant women exposed to CAB+RPV with live births. Methods Women of reproductive potential exposed to ≥ 1 dose of CAB+RPV (oral/LA) from ViiV-sponsored Phase 2/3/3b clinical treatment studies and the compassionate use program were included in this analysis and pregnancies identified. Per protocol, upon identification of pregnancy, CAB+RPV was discontinued and an alternative regimen initiated, with continued quarterly PK sampling for 52 weeks post last injection during long-term safety follow-up (LTFU). Descriptive characteristics of pregnant women and birth outcomes and available CAB and RPV PK during pregnancy for those with live births are summarized. Results As of March 31, 2021, 26/325 women of reproductive potential (age 18–49 years) became pregnant while exposed to CAB+RPV (5 oral, 21 LA [including 3 following LA discontinuation]). There were 11 live births (1 oral, 10 LA), of which 10 had no reported congenital abnormalities and 1 had reported congenital ptosis, in a pre-term infant with intrauterine growth restriction. There were 9 elective terminations and 6 miscarriages (5 in first 9 weeks of gestation). Ten women exposed to intramuscular CAB+RPV LA became pregnant with subsequent live birth outcomes, including 3 infants conceived during the PK tail in LTFU. All women were virologically suppressed at time of pregnancy identification. In women becoming pregnant on LA dosing, plasma CAB and RPV concentrations during pregnancy were within the range of expected concentrations in non-pregnant women. Two of 10 women with live births exposed to CAB+RPV LA continued LA therapy during pregnancy (compassionate use program participants). Conclusion Pregnancy outcomes in women exposed to CAB+RPV at conception are consistent with earlier findings. There was 1 reported congenital anomaly among 11 live births. CAB and RPV PK tail in pregnancy was within the expected range for non-pregnant women. Ongoing monitoring of birth defects within the antiretroviral pregnancy registry and pregnancy surveillance within the treatment program continues. Disclosures Parul Patel, PharmD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Susan L. Ford, PharmD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Mark Baker, PhD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Claudia Meyer, MBChB, MRCP, MSc, FRCPath, DTM&H, GlaxoSmithKline (Employee, Shareholder) Louise Garside, PhD, GlaxoSmithKline (Employee) Ronald D’Amico, DO, MSc, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Rodica Van Solingen-Ristea, MD, Janssen Research and Development (Employee)ViiV Healthcare (Employee) Herta Crauwels, PhD, Janssen (Employee) Joseph Polli, PhD, FAAPS, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Ciara Seal, BS, GlaxoSmithKline (Employee, Shareholder) Shanker Thiagarajah, MB ChB, GlaxoSmithKline (Employee, Shareholder) Eileen Birmingham, MD, MPH, Janssen Research and Development (Employee, Shareholder) William Spreen, PharmD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Bryan Baugh, MD, Janssen, Johnson & Johnson (Employee, Shareholder) Matthew Bosse, DO, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare Limited (Employee)

Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV

2020 ◽  
Author(s):  
Ashish Premkumar ◽  
Lynn M. Yee ◽  
Lia Benes ◽  
Emily S. Miller
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Median Time ◽  
Social Vulnerability ◽  
Viral Suppression ◽  
Foreign Born ◽  
Women Living With Hiv ◽  
Virologic Control ◽  
Clinical Records ◽  
Living With Hiv

Objective The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. Study Design This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. Results A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18–2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. Conclusion Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. Key Points

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