scholarly journals Antiretroviral therapy containing raltegravir to prevent mother-to-child transmission of HIV in infected pregnant women

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Diego M. Cecchini ◽  
Marina G. Martinez ◽  
Laura M. Morganti ◽  
Claudia G. Rodriguez
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Buenos Aires ◽  
Elective Cesarean Section ◽  
Late Presenter ◽  
Child Transmission ◽  
Median Viral Load ◽  
Elective Cesarean ◽  
Mother To Child

We conducted a retrospective study in a general hospital in Buenos Aires, Argentina (2009-2015) aimed at evaluating outcomes in HIV-infected pregnant women (HIPW), who were prescribed raltegravir (RAL)- containing antiretroviral therapy (ART). A total of 239 HIPW were enrolled in our study; among them 31 received RAL (12.9%) at different clinical stages: i) intensification (INS): addition of RAL to current ART because of detectable antepartum viral load, 13 (41.9%); ii) late presenter (LP): standard ART + RAL as fourth drug, 15 (48.4%); iii) treatment of resistant-HIV: 3 (9.7%). Median gestational age at RAL initiation was 34 weeks and median exposure was 30 days. In INS-group, median viral load (VL) decrease was 1.48 log10. In LPgroup, median VL decline was 2.15 log10. No clinical adverse events or maternal intolerance attributable to RAL were observed. Elective cesarean section was done in 51.7%; mild elevation of transaminases was observed in 35% of neonates. No vertical transmission was documented.

scholarly journals Advances and Failures in Preventing Perinatal Human Immunodeficiency Virus Infection

2009 ◽  
Vol 22 (3) ◽  
pp. 493-507 ◽  
Author(s):  
Ann M. Buchanan ◽  
Coleen K. Cunningham
Keyword(s):  
Antiretroviral Therapy ◽  
Breast Feeding ◽  
Unmet Need ◽  
Perinatal Transmission ◽  
Developed Countries ◽  
Elective Cesarean Section ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Perinatal Hiv ◽  
Mother To Child

SUMMARY An estimated 2.5 million children are currently living with HIV, the vast majority as a result of mother-to-child transmission. Prevention of perinatal HIV infection has been immensely successful in developed countries. A comprehensive package of services, including maternal and infant antiretroviral therapy, elective cesarean section, and avoidance of breast-feeding, has resulted in transmission rates of less than 2%. However, in developing countries, access to such services is often not available, as demonstrated by the fact that the vast majority of children with HIV live in Africa. Over the past few years, many developing nations have made great strides in improving access to much-needed services. Notably, in eastern and southern Africa, the regions most affected by HIV, mother-to-child-transmission coverage rates for HIV-positive women increased from 11% in 2004 to 31% in 2006. These successes are deserving of recognition, while not losing sight of the fact that much remains to be done; currently, an estimated 75% of pregnant women worldwide have an unmet need for antiretroviral therapy. Further work is needed to determine the optimal strategy for reducing perinatal transmission among women in resource-poor settings, with a particular need for reduction of transmission via breast-feeding.

Low Complication Rate Associated with Cesarean Section under Spinal Anesthesia for HIV-1–Infected Women on Antiretroviral Therapy

2002 ◽  
Vol 97 (2) ◽  
pp. 320-324 ◽  
Author(s):  
Michael S. Avidan ◽  
Philippa Groves ◽  
Margaret Blott ◽  
Jan Welch ◽  
Theresa Leung ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Postoperative Complications ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Elective Cesarean ◽  
Hiv 1

Background Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus (HIV) transmission from mother to infant. This study aimed to determine whether cesarean section done with spinal anesthesia on HIV-1-infected pregnant women taking antiretroviral therapy is associated with intraoperative hemodynamic instability, postoperative complications, or changes in immune function or HIV-1 viral load. Methods A case-controlled study was conducted over a 3-year period in a London academic hospital. Forty-four women infected with HIV-1 and a control group of 45 HIV-negative women undergoing cesarean sections were included. The main outcome measures included intraoperative blood pressure, heart rate, blood loss, and ephedrine requirements, and postoperative infective complications, blood transfusion, changes in blood HIV-1 viral load and lymphocyte subsets, and time to hospital discharge. Results There were no differences in hemodynamic stability and postoperative complications between the HIV-infected group and the controls. There was an acute postoperative increase in the CD4T lymphocyte count (P = 0.01), but the CD4T:CD8T ratio and viral load did not change. Conclusions Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications.

scholarly journals Mother-to-child transmission of HIV in Brazil during the years 2000 and 2001: results of a multi-centric study

2007 ◽  
Vol 23 (suppl 3) ◽  
pp. S379-S389 ◽  
Author(s):  
Regina Célia de Menezes Succi
Keyword(s):  
Elective Cesarean Section ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Transmission Rates ◽  
Elective Cesarean ◽  
Cd4 Lymphocyte ◽  
Year 2000 ◽  
Mother To Child

The objective of this study was to assess mother-to-child transmission rates of HIV in Brazil during the years 2000 and 2001, and to identify the maternal and neonatal variables that were associated with this transmission. It was a cross-sectional, observational study with retrospective data obtained from patient medical records. The children were followed at 63 medical sites situated in five geographical macro-regions of the country (20 States and the Federal Capital). Children enrolled were those that were born of HIV-infected mothers and it was necessary for the mothers to present documented proof of HIV-infection before or during pregnancy, at time of delivery or in the first three months after delivery. There were 2,924 children enrolled and mother-to-child transmission rates of HIV were 8.6% (95%CI: 7.2-10.2) for the year 2000 and 7.1% (95%CI: 5.8-8.6) for the year 2001. The following variables were associated with lower mother-to-child transmission rates of HIV: elective cesarean section, diagnosis of mother's infection before or during pregnancy, access to HIV viral load and T CD4+ lymphocyte count during prenatal care, greater birth weight and avoidance of breastfeeding.

Influence of short-course antenatal antiretroviral therapy on viral load and mother-to-child transmission in subsequent pregnancies among HIV-infected women

2012 ◽  
Vol 18 (2) ◽  
pp. 183-192 ◽  
Author(s):  
Clare E French ◽  
Pat A Tookey ◽  
Mario Cortina-Borja ◽  
Annemiek de Ruiter ◽  
Claire L Townsend ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Short Course ◽  
Mother To Child

Relation between HIV and Infant Feeding - A Review Article

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Jasmina D. Acharya ◽  
Rutu Patel ◽  
Nilofar Shaikh
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Breast Milk ◽  
Breast Feeding ◽  
Hiv Transmission ◽  
Medical Science ◽  
Review Article ◽  
Child Transmission ◽  
Maternal Viral Load ◽  
Mother To Child

Breast feeding increases the risk of HIV transmission from mother to child. Transmission through breast feeding is associated with increased maternal viral load in plasma and breast milk. Modern medical science suggests HIV infected women should give breast milk with accompanying prophylactic antiretroviral therapy to lower the risk of HIV transmission. According to Ayurveda, mother with vitiated breast milk should avoid breast feeding as it is responsible for developing many diseases in the child.

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