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Population-based survey of HIV sero-status and vertical transmission among naive pregnant women in Sokoto, Nigeria  [PDF]
Fiekumo Igbida Buseri, Charity Ngozi Okonkwo
Asian Journal of Medical Sciences , 2015, DOI: 10.3126/ajms.v6i3.11530
Abstract: Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria. Materials and Methods : This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond. Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ 2 analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ 2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ 2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530 Asian Journal of Medical Sciences Vol.6(3) 2015 49-57 ? ?
Human Immunodeficiency Virus (HIV) types Western blot (WB) band profiles as potential surrogate markers of HIV disease progression and predictors of vertical transmission in a cohort of infected but antiretroviral therapy na?ve pregnant women in Harare, Zimbabwe
Kerina Duri, Fredrik Müller, Felicity Z Gumbo, Nyaradzai E Kurewa, Simba Rusakaniko, Mike Z Chirenje, Munyaradzi P Mapingure, Babill Stray-Pedersen
BMC Infectious Diseases , 2011, DOI: 10.1186/1471-2334-11-7
Abstract: HIV type characterization was done in a cohort of infected pregnant women at 36 gestational weeks using WB test. Student-t test was used to determine maternal differences in mean full blood counts and viral load of mothers with and those without HIV gag antigen bands. Pearson Chi-square test was used to assess differences in lack of bands appearance with vertical transmission and lymphadenopathy.Among the 64 HIV infected pregnant women, 98.4% had pure HIV-1 infection and one woman (1.7%) had dual HIV-1/HIV-2 infections. Absence of HIV pol antigen bands was associated with acute infection, p = 0.002. All women with chronic HIV-1 infection had antibody reactivity to both the HIV-1 envelope and polymerase antigens. However, antibody reactivity to gag antigens varied among the women, being 100%, 90%, 70% and 63% for p24, p17, p39 and p55, respectively. Lack of antibody reactivity to gag p39 antigen was associated with disease progression as confirmed by the presence of lymphadenopathy, anemia, higher viral load, p = 0.010, 0.025 and 0.016, respectively. Although not statistically significant, women with p39 band missing were 1.4 times more likely to transmit HIV-1 to their infants.Absence of antibody reactivity to pol and gag p39 antigens was associated with acute infection and disease progression, respectively. Apart from its use in HIV disease diagnosis, WB test could also be used in conjunction with simpler tests like full blood counts and patient clinical assessment as a relatively cheaper disease monitoring tool required prior to accessing antiretroviral therapy for poor resource settings. However, there is also need to factor in the role of host-parasite genetics and interactions in disease progression.Acquired Immunodeficiency Syndrome (AIDS) is currently one of the most devastating diseases caused by HIV. Globally, in 2007 alone, 33 million people were living with HIV/AIDS and 20 million had died [1]. Studies have shown a cross-species transmission of HIV from a
Comorbidities in Children and Adolescents with AIDS Acquired by HIV Vertical Transmission in Vitória, Brazil  [PDF]
Sandra F. Moreira-Silva, Eliana Zandonade, Diana O. Frauches, Elisa A. Machado, Lays Ignacia A. Lopes, Lívia L. Duque, Polyana P. Querido, Angélica E. Miranda
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082027
Abstract: Background Studying diseases associated with AIDS is essential for establishing intervention strategies because comorbidities can lead to death. The objectives were to describe the frequency of comorbidities and verify their distribution according to demographic, epidemiological and clinical data as well as to classify diseases in children and adolescents with AIDS in Vitória, Brazil. Methods A retrospective cohort study was conducted among children with AIDS, as defined according to the criteria established by the Ministry of Health, who acquired HIV via vertical transmission, were aged 0 to 18 years, and were monitored at a referral hospital from January 2001 to December 2011. Results A total of 177 patients were included, of whom 97 were female (55%). There were 60 patients (34%) <1 year old, 67 patients (38%) between the ages of 1 and 5, and 50 patients (28%) ≥6 years of age included at the time of admission to the Infectious Diseases Ward. Regarding clinical-immunological classification, 146 patients (82.5%) showed moderate/severe forms of the disease at the time of admission into the Ward, and 26 patients (14.7%) died during the study. The most common clinical signs were hepatomegaly (81.62%), splenomegaly (63.8%), lymphadenopathy (68.4%) and persistent fever (32.8%). The most common comorbidities were anaemia (67.2%), pneumonia/septicaemia/acute bacterial meningitis (ABM) (64.2%), acute otitis media (AOM)/recurrent sinusitis (55.4%), recurrent severe bacterial infections (47.4%) and dermatitis (43.1%). An association between severe clinical-immunological classification and admission to the Ward for children aged less than one year old was found for several comorbidities (p<0.001). Conclusion Delayed diagnosis was observed because the majority of patients were admitted to the Infectious Diseases Ward at ≥1 year of age and were already presenting with serious diseases. The general paediatrician should be alert to this possibility to make an early diagnosis in children infected with HIV.
Hepatitis B Surface Antigen Carrier State among Asymptomatic Pregnant Women and Its Correlation with Vertical Transmission  [PDF]
Sasirekha Bakthavatchalu
International Journal of Research in Pharmacy and Science , 2012,
Abstract: Hepatitis B virus (HBV) is a public health problem worldwide. It is highly endemic in Asia and Sub-Saharan Africa. Horizontal and perinatal transmissions are thought to be major modes of transmissionin these countries. Therefore, the present study was carried out to assess the role of HBV in apparentlyhealthy pregnant women and to assess the impact of replicating status of HBV in asymptomatic carriermothers. Seroprevalence of Hepatitis B virus was determined among pregnant women attendingantenatal clinic. Serum samples were collected and screened for HBsAg, HBeAgand anti-HBe markersusing Enzyme Linked Immunosorbent Assay (ELISA). The overall prevalence of hepatitis B surfaceantigen among pregnant women was 7.8%. The participant women were mostly of age group of 21-25years. Infants born to asymptomatic HBsAg carrier mothers were followed up for 3 months todetermine the vertical transmission of HBV infection. The rate of transmission of infection fromHBsAg positive mothers to infants was 25% irrespective of HBsAg status, whereas it was nearly 100%in case of HBsAg positive mothers, supporting the conclusion that perinatal transmission is the majormode of transmission. The study revealed that prevalence of HBsAg carrier state in the study area wassignificant enough to start routine antenatal screening for HBsAg. Therefore, screening andimmunization of pregnant women and infants should be made mandatory in the antenatal and postnatalprogrammes in hospitals, for the eradication of HBV infection.
What is the Reason for Poor Outcome of Antepartum Immunoprophylaxis of Hepatitis B Immunoglobulin in Prevention of Vertical Hepatitis B Transmission?
Seyed Moayed Alavian,Bita Behnava
Hepatitis Monthly , 2007,
Abstract: Hepatitis B virus (HBV) infection is a serious global health problem, with 2 billion people infected worldwide, and 350 million suffering from chronic HBV infection. Hepatitis B infection is the 10th leading cause of death worldwide, and results in 500,000 to 1.2 million deaths per year caused by chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). HCC accounts for 320000 deaths per year (1). The risk of perinatal HBV transmission is greater for infants born from women who are positive for both HBsAg and HBeAg. The risk ranges from 70 to 90% for infants born from mothers who are positive for both HBsAg and HBeAg, in contrast to the 10-40% risk in infants born from mothers who are positive for HBsAg but negative for HBeAg (2, 3). Comparatively, East Asia has been found to have a higher prevalence of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa (4). More than 20 years have elapsed since 1984, when vaccination against hepatitis B began, first with a plasma-derived vaccine and later a recombinant DNA-derived vaccine, and during this period important changes have taken place in several aspects of this disease; the acute and chronic infection rates, the mortality of fulminant hepatitis B in infants; and the incidence of HCC have been effectively reduced by approximately 25%. Vaccination during childhood has produced adequate protection for up to 20 years later (5). Safe and effective vaccines against HBV infection have been available since 1982. The implementations of mass immunization programs, which have been recommended by the World Health Organization since 1991, have dramatically decreased the incidence of HBV infection among infants, children, and adolescents in many countries (1). Vaccination alone did not induce immunity against hepatitis B in high-risk children (whose mothers are HBsAg positive) and it seems that routine screening of pregnant women is necessary for determining whether neonates need hepatitis B immunoglobulin (HBIG) after birth (6). On the other hand, with combination of HBV vaccine and HBIG in neonatal the chance of transmission can be avoided significantly, but not totally (7).We read with great interest the valuable article by Xiao et al. (8). The aim of this study was to explore the possible efficacy of using HBIG during the third trimester of pregnancy to prevent intrauterine transmission of HBV. A total of 469 pregnant women with chronic HBV infection, that consisted of 126 women with HBeAg positive (group 1) and 343 women with HBeAg negative
Detección de infección por VIH a través de test rápido en mujeres embarazadas: Una estrategia exitosa para disminuir su transmisión vertical Detection of HIV infection in pregnant women by rapid testing: a successful strategy to reduce its vertical transmission  [cached]
Jorge Quian R,Ana Visconti G,Stella Gutiérrez R,Ana Galli R
Revista chilena de infectología , 2005,
Abstract: En Uruguay existe un gran porcentaje de mujeres que no controlan su embarazo y donde la transmisión vertical de la infección por VIH alcanza al 50%. Objetivo: conocer la prevalencia de infección por VIH en mujeres embarazadas que desconocen su estado serológico, y que no controlan o controlan mal su gestación, y disminuir la transmisión vertical. Pacientes y métodos: entre enero de 2002 y enero de 2004 se realizó el test rápido para detectar infección por VIH a toda mujer embarazada que no supiera su condición serológica y que consultara en el Servicio Gineco-Obstétrico del Centro Hospitalario Pereira Rossell. De acuerdo a la edad gestacional se tomaban las medidas profilácticas consideradas más adecuadas. Se calculó la prevalencia de infección por VIH en esas mujeres y el porcentaje de transmisión a sus hijos. Resultados: hubo 34.338 consultas obstétricas y se realizaron 4.599 tests rápidos. Se detectaron 58 mujeres positivas, 8 de ellas conocían previamente su condición serológica. La prevalencia de infección por VIH fue de 1,1% (IC95% 0,8-1,4). Hubo un falso positivo y cuatro abortos. Diez mujeres abandonaron los controles. Doce recibieron antiretrovirales durante el embarazo por más de una semana. Se controlaron 39 ni os y 2 fueron infectados. El porcentaje de transmisión fue de 5,1%. Como algunas mujeres y ni os se perdieron en el seguimiento, es necesario complementar la estrategia de un screening de test rápido para infección por VIH con otras medidas como consejería y entrevista con asistente social para optimizar estos resultados A high percentage of Uruguayan pregnant women are not under medical control. As a consequence, vertically transmission of HIV infection reaches to 50%. The aim of this study was to know the prevalence of HIV infection in pregnant women who did not know their serological status and to decrease mother-to-child transmission. Patients and Methods: from January 2002 to January 2004 the HIV rapid test was performed to every pregnant woman that assisted to a public Uruguayan hospital unaware of her condition. The proper prophylactic decisions were adopted according to gestational age. The newborn infants were classified according to CDC criteria. HIV infection prevalence in pregnant women and in their newborn infants was calculated. Results: there were 34.338 obstetric consultations and 4.599 rapid tests were performed. Fifty-nine turned out positive in 58 women, 8 of them knew their serological status previously. The HIV infection prevalence was 1.1% (IC95% 0.8-1.4). Five cases were discharged: 1 false positive and 3 miscarr
Acceptability and Barriers to Uptake of Voluntary Counselling and Testing for HIV amongst Pregnant Women in Nigeria
Charles Oluwole Omolase,Samuel Oladiran Faturoti,Bukola Olateju Omolase
TAF Preventive Medicine Bulletin , 2010,
Abstract: AIM: This study was designed to determine the acceptability of voluntary counselling and testing (VCT) for HIV and identify possible barriers to it s uptake amongst pregnant women in a Nigerian community. METHODS: One hundred and twenty seven consenting pregnant women attending antenatal clinic at Federal Medical Centre, Owo were randomly selected and interviewed by the authors and two trained assistants. The study was conducted between August and October, 2007. The information obtained with the aid of semi structured questionnaire included their bio data, awareness about VCT and vertical transmission of HIV-AIDS. Other information obtained included acceptability of VCT and barriers to its uptake. RESULT: Majority (85%) were aware about vertical transmission of HIV, most (83.5%) knew of VCT. They were predominantly willing to accept VCT (77.2%) and were ready to recommend VCT to others(76.2%). The main identified barriers to uptake of voluntary counseling were fear of possible outcome (82.7%) and risk of divorce (70.9%). CONCLUSION: Most respondents were aware of voluntary counselling and testing for HIV as well as the vertical transmission of HIV. Majority were willing to accept HIV test and recommend same to others. Barriers to uptake of HIV test included fear of possible outcome, lack of felt need, stigmatization and financial constraint. There is need to extend voluntary counselling and testing for HIV to all antenatal patients. [TAF Prev Med Bull 2010; 9(4): 309-314]
Projetos de vida de adultos jovens portadores de HIV por transmiss o vertical: estudo exploratório com usuários de um ambulatório de infectologia Life projects of young adults with HIV acquired by vertical transmission: an exploratory study with patients of an infectious diseases' outpatients department  [cached]
Lédice Lino de Oliveira,Marinella Della Negra,Maria Cezira Fantini Nogueira-Martins
Saúde e Sociedade , 2012,
Abstract: Esta pesquisa teve o intuito de conhecer os projetos de vida de jovens adultos que convivem com o HIV/aids a partir da transmiss o vertical, com rela o a: estudo, trabalho e constitui o familiar. Outro objetivo foi o de conhecer sua vivência no que diz respeito à assistência recebida. Como instrumentos, foram utilizados: questionário sociodemográfico e entrevista semiestruturada. Foram realizadas 16 entrevistas com jovens de idade entre 18 e 22 anos, usuários de um ambulatório de um hospital público especializado na área de Infectologia. O material obtido nas entrevistas foi analisado segundo os princípios da análise temática. Foram encontradas seis categorias temáticas: estudo e escolaridade; trabalho e emprego; sexualidade e constitui o familiar; vivência de preconceito; ades o ao tratamento; acolhimento. Os entrevistados referiram que a escola é importante meio para a inser o social e para a conquista da autonomia. O trabalho foi apresentado como principal fonte de subsistência e de independência. O exercício da sexualidade foi marcado pela situa o de existência do HIV, determinando cuidados especiais; quanto à conjugalidade, os projetos dos entrevistados s o variados: uni o informal, casamento oficial, vida sem c njuge. No que diz respeito à maternidade/paternidade, os projetos s o marcadamente influenciados pela portabilidade do HIV, despertando dúvidas e receios. Os entrevistados relataram a existência do preconceito em vários contextos. Quanto à ades o ao tratamento, revelaram a existência tanto de dificuldades como de mecanismos criados para enfrentá-las. O acolhimento por parte de familiares, amigos e profissionais da saúde foi considerado fundamental para o desenvolvimento e a manuten o de seus projetos de vida. This research had the intention to understand the life projects of young adults living with HIV/Aids infected through vertical transmission: how they deal with studies, work and with building a family. Another objective was to know their experiences regarding health assistance received. The research method was: socio-demographic questionnaires and semi-structured interviews. Sixteen interviews were performed with people between eighteen and twenty two years-old who were users of a public out patients service specialized in Infectious Diseases. Data from the interviews was analyzed according to the principles of thematic analysis. Six thematic categories were found: study and schooling; labor and employment; sexuality and family building; experiences of prejudice; adherence to treatment and reception at the health service.I Interv
The challenge of the reference and counter-reference system in the prenatal assistance to pregnant women with infectious diseases
Figueiredo, Elisabeth N.;Vianna, Lucila A. C.;Peixe, Marina B.;Ramos, Valdete M.;Succi, Regina C. M.;
Anais da Academia Brasileira de Ciências , 2009, DOI: 10.1590/S0001-37652009000300018
Abstract: the objective of this study was to determine the prevalence of infectious diseases, such as syphilis, acquired immune deficiency syndrome (aids) and hepatitis b and c, in pregnant women who undertook their prenatal care in thirteen basic health units (bhu) in s?o paulo city. the efficiency of the reference and counter-reference system in such prenatal infectious diseases was evaluated considering the medical recordings of the final result of the pregnancy and the vertical transmission rates of these diseases. it consists of an epidemiologic study whose observations were based on the notes of the prenatal medical and nurse records of pregnant women who had infectious diseases susceptible to vertical transmission and final infectious status registers of their concepts. women's syphilis prevalence was 0. 86%, hiv and hepatitis b was 0. 22% and hepatitis c was 0. 36%. it's possible to conclude that there is no register of the reference and counter-reference system of these infectious diseases analyzed at the thirteen basic health units of the south-east region of s?o paulo city evaluated in 2005. this lack of register makes it impossible to know the preventive measures taken and the vertical transmission rates. making the professionals and the health coordination authorities aware of the importance of the dynamic of the prenatal attendance is necessary.
To what extent could performance-based schemes help increase the effectiveness of prevention of mother-to-child transmission of HIV (PMTCT) programs in resource-limited settings? a summary of the published evidence
Hapsatou Touré, Martine Audibert, Fran?ois Dabis
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-702
Abstract: In sub-Saharan African countries with high prevalence rates, pediatric HIV/AIDS acquired through mother-to-child transmission (MTCT) can in largely be prevented by using well-established biomedical interventions. Logistical and socio-cultural barriers continue, however, to undermine the successful prevention of MTCT (PMTCT). In this paper, we review reports on maternal, neonatal and child health, as well as HIV care and treatment services that look at program incentives.These studies suggest that comprehensive PMTCT strategies aiming to maximize health-worker motivation in developing countries must involve a mix of both financial and non-financial incentives. The establishment of robust ethical and regulatory standards in public-sector HIV care centers could reduce barriers to PMTCT service provision in sub-Saharan Africa and help them in achieving universal PMTCT targets.The risk of mother-to-child transmission (MTCT) of HIV has declined from 35% to less than 2% thanks to the development of biomedical interventions that can be provided to women and/or children during pregnancy, labor, delivery and breastfeeding [1,2]. Vertical HIV transmission-the main route of pediatric HIV infection-has thus virtually disappeared in high-income settings, where integrated and comprehensive strategic services for prevention of MTCT (PMTCT) have been successful and are now the standard of care [3]. Conversely, vertical HIV transmission remains an important public health issue in the developing world because the scale-up of PMTCT services so far has been slow and highly uneven [4-7]. Too few pregnant women in low- and middle-income countries are aware of their HIV status. In 2009, only 26% of women attending antenatal care received an HIV test, and 53% of those who were found to be HIV-infected received an antiretroviral prophylaxis for PMTCT, which rarely contained the most powerful combinations of antiretroviral drugs (ARV) [8]. An estimated 430,000 children were newly infected wit
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