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[PMID]:29304083
[Au] Autor:Adachi K; Xu J; Yeganeh N; Camarca M; Morgado MG; Watts DH; Mofenson LM; Veloso VG; Pilotto JH; Joao E; Gray G; Theron G; Santos B; Fonseca R; Kreitchmann R; Pinto J; Mussi-Pinhata MM; Ceriotto M; Machado DM; Bryson YJ; Grinsztejn B; Moye J; Klausner JD; Bristow CC; Dickover R; Mirochnick M; Nielsen-Saines K; NICHD HPTN 040 Study Team
[Ad] Endereço:David Geffen UCLA School of Medicine, Los Angeles, CA, United States of America.
[Ti] Título:Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission.
[So] Source:PLoS One;13(1):e0189851, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. METHODOLOGY: Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. RESULTS: A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1-3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5-7.7). Individually, maternal CMV (aOR 4.4 1.5-13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2-7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. CONCLUSION: HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT. TRIAL REGISTRATION: NCT00099359.
[Mh] Termos MeSH primário: Infecções por HIV/complicações
Infecções por HIV/transmissão
Transmissão Vertical de Doença Infecciosa
Complicações Infecciosas na Gravidez
Doenças Sexualmente Transmissíveis/complicações
[Mh] Termos MeSH secundário: Adolescente
Adulto
Infecções por Chlamydia/complicações
Chlamydia trachomatis
Estudos Transversais
Feminino
Gonorreia/complicações
Seres Humanos
Lactente
Recém-Nascido
Meia-Idade
Gravidez
Estudos Retrospectivos
Fatores de Risco
Sífilis/complicações
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189851


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[PMID]:28449969
[Au] Autor:Le Doare K; Faal A; Jaiteh M; Sarfo F; Taylor S; Warburton F; Humphries H; Birt J; Jarju S; Darboe S; Clarke E; Antonio M; Foster-Nyarko E; Heath PT; Gorringe A; Kampmann B
[Ad] Endereço:Centre for International Child Health, Imperial College London, Norfolk Place, London W2 1PG, UK,; Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0TE, UK; Vaccines & Immunity Theme, MRC Unit The Gambia, Atlantic Road, Fajara, Gambia
[Ti] Título:Association between functional antibody against Group B Streptococcus and maternal and infant colonization in a Gambian cohort.
[So] Source:Vaccine;35(22):2970-2978, 2017 05 19.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Vertical transmission of Group B Streptococcus (GBS) is a prerequisite for early-onset disease and a consequence of maternal GBS colonization. Disease protection is associated with maternally-derived anti-GBS antibody. Using a novel antibody-mediated C3b/iC3b deposition flow cytometry assay which correlates with opsonic killing we developed a model to assess the impact of maternally-derived functional anti-GBS antibody on infant GBS colonization from birth to day 60-89 of life. METHODS: Rectovaginal swabs and cord blood (birth) and infant nasopharyngeal/rectal swabs (birth, day 6 and day 60-89) were obtained from 750 mother/infant pairs. Antibody-mediated C3b/iC3b deposition with cord and infant sera was measured by flow cytometry. RESULTS: We established that as maternally-derived anti-GBS functional antibody increases, infant colonization decreases at birth and up to three months of life, the critical time window for the development of GBS disease. Further, we observed a serotype (ST)-dependent threshold above which no infant was colonized at birth. Functional antibody above the upper 95th confidence interval for the geometric mean concentration was associated with absence of infant GBS colonization at birth for STII (p<0.001), STIII (p=0.01) and STV (p<0.001). Increased functional antibody was also associated with clearance of GBS between birth and day 60-89. CONCLUSIONS: Higher concentrations of maternally-derived antibody-mediated complement deposition are associated with a decreased risk of GBS colonization in infants up to day 60-89 of life. Our findings are of relevance to establish thresholds for protection following vaccination of pregnant women with future GBS vaccines.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/imunologia
Imunidade Materno-Adquirida
Transmissão Vertical de Doença Infecciosa
Infecções Estreptocócicas/imunologia
Streptococcus/crescimento & desenvolvimento
Streptococcus/imunologia
[Mh] Termos MeSH secundário: Adulto
Anticorpos Antibacterianos/sangue
Portador Sadio
Criança
Pré-Escolar
Estudos de Coortes
Complemento C3b/imunologia
Feminino
Sangue Fetal/imunologia
Citometria de Fluxo
Gâmbia/epidemiologia
Seres Humanos
Técnicas Imunológicas
Lactente
Recém-Nascido
Estudos Longitudinais
Mães
Nasofaringe/microbiologia
Proteínas Opsonizantes
Gravidez
Complicações Infecciosas na Gravidez/microbiologia
Infecções Estreptocócicas/epidemiologia
Infecções Estreptocócicas/transmissão
Streptococcus/classificação
Streptococcus/isolamento & purificação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Bacterial); 0 (Opsonin Proteins); 80295-43-8 (Complement C3b)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29236362
[Au] Autor:Rogers AJ; Akama E; Weke E; Blackburn J; Owino G; Bukusi EA; Oyaro P; Kwena ZA; Cohen CR; Turan JM
[Ad] Endereço:Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
[Ti] Título:Implementation of repeat HIV testing during pregnancy in southwestern Kenya: progress and missed opportunities.
[So] Source:J Int AIDS Soc;20(4), 2017 Dec.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Repeat HIV testing during the late antenatal period is crucial to identify and initiate treatment for pregnant women with incident HIV infection to prevent perinatal HIV transmission and keep mothers alive. In 2012, the Kenya Ministry of Health adopted international guidelines suggesting that pregnant women be offered retesting three months after an initial negative HIV test. Our objectives were to determine the current rate of antenatal repeat HIV testing; identify successes, missed opportunities and factors associated with retesting; and estimate the incidence of HIV during pregnancy. METHODS: Retrospective analysis of longitudinal data was conducted for a cohort of 2145 women attending antenatal care clinic at a large district hospital in southwestern Kenya. Data were abstracted from registers for all women who attended the clinic from the years 2011 to 2014. RESULTS: Although 90.2% of women first came to clinic prior to their third trimester and 27.5% had at least four clinic visits, 58.0% of all women went to delivery without a retest. Missed opportunities for retesting included not returning to clinic at all, not returning when eligible, or late gestational age (>28 weeks) at first clinic visit making them ineligible for retesting (accounting for 14.2%, 26.8% and 9.6% of all clinic attendees respectively); and failure to be retested even when eligible at one or more visits (accounting for 73.2% of eligible returnees). Being unmarried and aged 20 or younger was associated with an increase in mean gestational age of first visit by 2.52 weeks (95% CI: 1.56, 3.48) and a 2.59 increased odds (95% CI: 1.90, 3.54) of failing to return to clinic, compared to those who were married and over 20 years of age. On retest, two women tested HIV positive, suggesting an incidence rate of 4.4 per 100 person-years. After adjusting for potential confounders, only later year of last menstrual period (2013 vs. 2012 and 2011) was associated with retesting. CONCLUSIONS: Adoption of retesting guidelines in 2012 appears to have successfully increased retesting rates, but missed opportunities to identify incident HIV infection during pregnancy may contribute to continuing high rates of perinatal HIV transmission in southwestern Kenya.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Complicações Infecciosas na Gravidez/diagnóstico
[Mh] Termos MeSH secundário: Feminino
Infecções por HIV/prevenção & controle
Infecções por HIV/transmissão
Seres Humanos
Incidência
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Quênia
Programas de Rastreamento
Gravidez
Complicações Infecciosas na Gravidez/epidemiologia
Cuidado Pré-Natal
Diagnóstico Pré-Natal
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25036


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[PMID]:29351561
[Au] Autor:Snijdewind IJM; Smit C; Godfried MH; Bakker R; Nellen JFJB; Jaddoe VWV; van Leeuwen E; Reiss P; Steegers EAP; van der Ende ME
[Ad] Endereço:Department of Internal Medicine, Section Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
[Ti] Título:Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age.
[So] Source:PLoS One;13(1):e0191389, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. MATERIALS AND METHODS: We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight <10th percentile for gestational age), low birth weight and preterm delivery. RESULTS: A total of 1392 children born to 1022 mothers were included. Of these, 331 (23.8%) children were SGA. Women starting cART before conception had an increased risk of having a SGA infant compared to women starting cART after conception (OR 1.35, 95% CI 1.03-1.77, p = 0.03). The risk for SGA was highest in women who started a protease inhibitor-(PI) based regimen prior to pregnancy, compared with women who initiated PI-based cART during pregnancy. While the association of preterm delivery and preconception cART was significant in univariate analysis, on multivariate analysis only a non-significant trend was observed (OR 1.39, 95% CI 0.94-1.92, p = 0.06) in women who had started cART before compared to after conception. In multivariate analysis, the risk of low birth weight (OR 1.34, 95% CI 0.94-1.92, p = 0.11) was not significantly increased in women who had started cART prior to conception compared to after conception. CONCLUSION: In our cohort of pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction resulting in SGA. Data showed a non-significant trend in the risk of PTD associated with preconception use of cART compared to its use after conception. More studies are needed with regard to the mechanisms taking place in the placenta during fetal growth in pregnant HIV-positive women using cART. It will only be with this knowledge that we can begin to understand the potential impact of HIV and cART on the fetus, in order to be able to determine the optimal individualised drug regimen for HIV-infected women of childbearing age.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/efeitos adversos
Infecções por HIV/complicações
Infecções por HIV/tratamento farmacológico
Complicações Infecciosas na Gravidez/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/administração & dosagem
Estudos de Coortes
Quimioterapia Combinada
Feminino
Retardo do Crescimento Fetal/etiologia
Infecções por HIV/transmissão
Seres Humanos
Recém-Nascido de Baixo Peso
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Masculino
Países Baixos
Cuidado Pré-Concepcional/métodos
Gravidez
Resultado da Gravidez
Nascimento Prematuro/etiologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191389


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[PMID]:29465561
[Au] Autor:Pollock KM; Pintilie H; Foster C; Fidler S
[Ad] Endereço:Section of Virology, Department of Medicine, Imperial College London.
[Ti] Título:Cross-sectional study of CD4: CD8 ratio recovery in young adults with perinatally acquired HIV-1 infection.
[So] Source:Medicine (Baltimore);97(8):e9798, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Antiretroviral therapy (ART) has improved survival into adulthood for young people with perinatally acquired HIV-1 (yp-PaHIV), but long-term prognosis remains unclear. We hypothesized that on-going immune activation, reflected in the failure of CD4:CD8 ratio normalization would be observed in yp-PaHIV, despite ART.A cross-sectional study of routinely collected clinical data from a cohort of yp-PaHIV (≥16 years).Data were collected from records of individuals attending a specialist clinic for yp-PaHIV transitioning to adult care. CD4:CD8 ratio and proportion with CD4:CD8 ratio ≥1, demographic data and viral parameters, including HIV-1 viral load (VL) and human cytomegalovirus (CMV) IgG, were analyzed with IBM SPSS Statistics v22.A total of 115 yp-PaHIV, median (IQR) age 22.0 (20.0-24.0) years, were studied, of whom 59 were females, and the majority were Black African 75/115 (65.2%). Where measured, CMV antibodies were frequently detected (71/74, 95.9%) and CMV IgG titre was inversely associated with CD4:CD8 ratio, (Rho -0.383, P = .012). Of those taking ART, 69 out of 90 (76.7%) yp-PaHIV had suppressed HIV viremia (<50 RNA copies/mL) and recovery of CD4:CD8 ratio to ≥1 was seen in 26 out of 69 (37.7%) with suppressed HIV viremia. Persistence of low CD4:CD8 ratio was observed even in those with a CD4 count ≥500 cells/µL, where 28/52 (53.8%) had a CD4:CD8 ratio <1. Of those with suppressed viremia, the median (IQR) age for starting ART was 8.0 (5.0-12.8) years and CD4:CD8 ratio was inversely associated with age at ART start, Rho -0.348, (P = .028).In this cohort of yp-PaHIV, despite lifelong HIV infection and widespread CMV coinfection, CD4:CD8 ratio recovery rate was comparable to adults treated in acute infection. Where persistence of CD4:CD8 ratio abnormality was observed, on-going immune activation may have significance for non-AIDS outcomes. Taken together our findings indicate immune resilience to be a feature of these adult survivors of perinatally acquired HIV infection, which can be supported with early antiretroviral therapy.
[Mh] Termos MeSH primário: Relação CD4-CD8
Infecções por HIV/imunologia
Infecções por HIV/transmissão
HIV-1/imunologia
Transmissão Vertical de Doença Infecciosa
[Mh] Termos MeSH secundário: Fatores Etários
Fármacos Anti-HIV/uso terapêutico
Coinfecção
Estudos Transversais
Infecções por Citomegalovirus/complicações
Infecções por Citomegalovirus/imunologia
Feminino
Infecções por HIV/complicações
Infecções por HIV/tratamento farmacológico
Seres Humanos
Masculino
Fatores Sexuais
Carga Viral
Viremia/complicações
Viremia/tratamento farmacológico
Viremia/imunologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009798


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[PMID]:29364979
[Au] Autor:Thomson KA; Telfer B; Opondo Awiti P; Munge J; Ngunga M; Reid A
[Ad] Endereço:Médecins Sans Frontières (MSF) Operational Centre Brussels, Nairobi, Kenya.
[Ti] Título:Navigating the risks of prevention of mother to child transmission (PMTCT) of HIV services in Kibera, Kenya: Barriers to engaging and remaining in care.
[So] Source:PLoS One;13(1):e0191463, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed. Using an inductive exploratory approach, four researchers coded the data and identified key themes. Five themes emerged from the data that may influence attrition from PMTCT service in this setting: 1) HIV in the context of Kibera, 2) knowledge of HIV status, 3) knowledge of PMTCT, 4) disclosure of HIV status, and 5) male partner support for PMTCT services. A new HIV diagnosis during pregnancy immediately triggered an ongoing risk assessment of perceived hazards in the home, community, and clinic environments that could occur as a result of female participation in PMTCT services. Male partners were a major influence in this risk assessment, but were generally unaware of PMTCT services. To preserve relationships with male partners, meet community expectations of womanhood, and maintain confidentiality while following recommendations of healthcare providers, women had to continuously weigh the risks and benefits of PMTCT services and interventions. Community-based HIV testing and PMTCT education, male involvement in antenatal care, and counseling customized to assist each woman in her own unique risk assessment, may improve uptake of and retention in care and optimize the HIV prevention benefit of PMTCT interventions.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Infecções por HIV/transmissão
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Complicações Infecciosas na Gravidez
[Mh] Termos MeSH secundário: Criança
Feminino
Infecções por HIV/complicações
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Recém-Nascido
Quênia
Masculino
Organizações
Participação do Paciente
Gravidez
Complicações Infecciosas na Gravidez/terapia
Cuidado Pré-Natal
Medição de Risco
Gestão de Riscos
Parceiros Sexuais/psicologia
Revelação da Verdade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191463


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[PMID]:29360870
[Au] Autor:Omosun YO; Blackstock AJ; Williamson J; van Eijk AM; Ayisi J; Otieno J; Lal RB; Ter Kuile FO; Slutsker L; Shi YP
[Ad] Endereço:Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
[Ti] Título:Association of maternal KIR gene content polymorphisms with reduction in perinatal transmission of HIV-1.
[So] Source:PLoS One;13(1):e0191733, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The role of killer cell immunoglobulin-like receptors (KIRs) in the transmission of HIV-1 has not been extensively studied. Here, we investigated the association of KIR gene content polymorphisms with perinatal HIV-1 transmission. The KIR gene family comprising 16 genes was genotyped in 313 HIV-1 positive Kenyan mothers paired with their infants. Gene content polymorphisms were presented as presence of individual KIR genes, haplotypes, genotypes and KIR gene concordance. The genetic data were analyzed for associations with perinatal transmission of HIV. There was no association of infant KIR genes with perinatal HIV-1 transmission. After adjustment for gravidity, viral load, and CD4 cell count, there was evidence of an association between reduction in perinatal HIV-1 transmission and the maternal individual KIR genes KIR2DL2 (adjusted OR = 0.50; 95% CI: 0.24-1.02, P = 0.06), KIR2DL5 (adjusted OR = 0.47; 95% CI: 0.23-0.95, P = 0.04) and KIR2DS5 (adjusted OR = 0.39; 95% CI: 0.18-0.80, P = 0.01). Furthermore, these maternal KIR genes were only significantly associated with reduction in perinatal HIV transmission in women with CD4 cell count ≥ 350 cells/ µl and viral load <10000 copies/ml. Concordance analysis showed that when both mother and child had KIR2DS2, there was less likelihood of perinatal HIV-1 transmission (adjusted OR = 0.44; 95% CI: 0.20-0.96, P = 0.039). In conclusion, the maternal KIR genes KIR2DL2, KIR2DL5, KIR2DS5, and KIR2DS2 were associated with reduction of HIV-1 transmission from mother to child. Furthermore, maternal immune status is an important factor in the association of KIR with perinatal HIV transmission.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Polimorfismo Genético
Complicações Infecciosas na Gravidez/prevenção & controle
Receptores KIR/genética
[Mh] Termos MeSH secundário: Adulto
Contagem de Linfócito CD4
Feminino
Genótipo
Infecções por HIV/transmissão
HIV-1/isolamento & purificação
Haplótipos
Seres Humanos
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Receptors, KIR)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191733


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[PMID]:28454556
[Au] Autor:Daw MA; El-Bouzedi A; Ahmed MO; Dau AA; In association with the Libyan Study Group of Hepatitis & HIV
[Ad] Endereço:Department of Medical Microbiology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya. mohamedadaw@gmail.com.
[Ti] Título:Molecular and epidemiological characterization of HIV-1 subtypes among Libyan patients.
[So] Source:BMC Res Notes;10(1):170, 2017 Apr 28.
[Is] ISSN:1756-0500
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The epidemiological and clinical aspects of human immunodeficiency virus subtypes are of great interest worldwide. These subtypes are rarely studied in North African countries. Libya is a large country with the longest coast on the Mediterranean Sea, facing the Southern European countries. Studies on the characterization of HIV-1 subtypes are limited in Libya. This study aimed to determine the magnitude of the HIV problem among the Libyan population and to better understand the genetic diversity and the epidemiologic dynamics of HIV 1, as well as to correlate that with the risk factors involved. METHODS: A total of 159 HIV-1 strains were collected from 814 HIV positive patients from the four Libyan regions during a 16-year period (1995-2010). To determine the HIV-1 subtypes, genetic analysis and molecular sequencing were carried out using provirus polygene. Epidemiologic and demographic information was obtained from each participant and correlated with HIV-1 subtypes using logistic regression. RESULTS: The overall prevalence of HIV among Libyans ranged from 5 to 10 per 100,000 during the study period. It was higher among intravenous drug users (IVDUs) (53.9%), blood recipients (25.9%) and heterosexuals (17.6%) than by vertical transmission (2.6%). Prevalence was higher among males aged 20-40 years (M:F 1:6, P > 0.001). Among the 159 strains of HIV-1 available for typing, 117 strains (73.6%) were subtype B, 29 (18.2%) were CRF02_AG, and 13 (8.2%) were subtype A. HIV-1 subtype B was the most prevalent all over the country, and it was more prevalent in the Northern region, particularly among IVDUs (P < 0.001). GRF02_AG was common in the Eastern region, particularly among blood recipients while subtype A emerged in the Western region, particularly among IVDUs. CONCLUSIONS: HIV-1 infection is emerging in Libya with a shifting prevalence of subtypes associated with the changing epidemiology of HIV-1 among risk groups. A genetic analysis of HIV-1 strains demonstrated low subtype heterogeneity with the evolution of subtype B, and CRF_20 AG, as well as HIV-1 subtype A. Our study highlights the importance of expanded surveillance programs to control HIV infection and the necessity of introducing public health strategies to target the risk groups, particularly IVDUs.
[Mh] Termos MeSH primário: Infecções por HIV/epidemiologia
Infecções por HIV/transmissão
HIV-1/genética
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos
Filogenia
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Transfusão de Sangue
Feminino
Infecções por HIV/complicações
Infecções por HIV/virologia
HIV-1/classificação
HIV-1/isolamento & purificação
Seres Humanos
Líbia/epidemiologia
Masculino
Meia-Idade
Epidemiologia Molecular
Tipagem Molecular
Prevalência
Vigilância em Saúde Pública
Fatores de Risco
Fatores Sexuais
Abuso de Substâncias por Via Intravenosa/complicações
Abuso de Substâncias por Via Intravenosa/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s13104-017-2491-2


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[PMID]:28452911
[Au] Autor:Powell AM; DeVita JM; Ogburu-Ogbonnaya A; Peterson A; Lazenby GB
[Ad] Endereço:Department of Obstetrics and Gynecology, The Medical University of South Carolina, Charleston, SC.
[Ti] Título:The Effect of HIV-Centered Obstetric Care on Perinatal Outcomes Among a Cohort of Women Living With HIV.
[So] Source:J Acquir Immune Defic Syndr;75(4):431-438, 2017 08 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Elimination of perinatal transmission is possible but limited by missed care opportunities. Our objective was to investigate the effects of HIV-centered obstetric care (HCC) on missed care opportunities and perinatal HIV transmission in 2 obstetric cohorts at our institution from 2000 to 2014. METHODS: This was a retrospective cohort study of HIV-exposed mother-infant pairs delivering from 2000 to 2014, analyzed according to SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guidelines. Before 2009, women received care in high-risk obstetric care (HRC); subsequently, an HCC service was established. Women who received HRC vs HCC obstetric care were compared to determine differences in maternal and neonatal outcomes. Continuous variables were compared with Student t test and Wilcoxon rank sum tests. Categorical variables were compared using χ test and Fisher exact test. Logistic regression analyses were performed to determine factors associated with outcomes of interest. RESULTS: Over 14 years, 161 women delivered 217 HIV-exposed infants; 78 (36%) women received HCC. Two perinatal HIV transmissions (1.5%) occurred in HRC group compared with none in the HCC group (P = 0.3). Women in HCC were more likely to have HIV RNA viral load <1000 copies per milliliter at delivery (12% vs 26%, P = 0.02), have a contraception plan before delivery (93% vs 60%, P < 0.001), return for postpartum evaluation (80% vs 63%, P = 0.01), and have undetectable HIV viral load postpartum (50 copies per milliliter vs 2067, P < 0.0001). CONCLUSIONS: HCC can potentially reduce the risk of perinatal HIV transmission by improving maternal virologic control during pregnancy and postpartum and increasing postpartum contraceptive use.
[Mh] Termos MeSH primário: Infecções por HIV/tratamento farmacológico
Infecções por HIV/prevenção & controle
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Serviços de Saúde Materna
Assistência Centrada no Paciente/normas
Complicações Infecciosas na Gravidez/tratamento farmacológico
Qualidade da Assistência à Saúde/normas
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/uso terapêutico
Contagem de Linfócito CD4
Feminino
Seres Humanos
Recém-Nascido
Saúde Materna
Serviços de Saúde Materna/normas
Período Pós-Parto
Gravidez
Complicações Infecciosas na Gravidez/virologia
RNA Viral
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
Carga Viral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (RNA, Viral)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001432


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[PMID]:29351333
[Au] Autor:Ramírez-Ramírez A; Sánchez-Serrano E; Loaiza-Flores G; Plazola-Camacho N; Rodríguez-Delgado RG; Figueroa-Damián R; Domínguez-Castro M; López-Martínez M; Flores-García Z; Hernández-Pineda J
[Ad] Endereço:Departement of Infectology and Immunology, National Institute of Perinatology, Mexico City, Mexico.
[Ti] Título:Simultaneous quantification of four antiretroviral drugs in breast milk samples from HIV-positive women by an ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method.
[So] Source:PLoS One;13(1):e0191236, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The primary strategy to avoid mother-to-child transmission of human immunodeficiency virus (HIV) through breastfeeding is administration of highly active antiretroviral therapy (HAART) to HIV-positive pregnant women. Because significant changes in the pharmacokinetics of antiretroviral (ARV) drugs occur during pregnancy, quantifying HAART and the viral load in breast milk in this population is essential. Here, we developed an analytical assay for the simultaneous quantification of four ARV drugs in breast milk using ultra-performance liquid chromatography coupled to tandem mass spectrometry. We validated this method following Mexican and international guidelines. ARV drugs. We extracted the ARV drugs from 200 µL samples of breast milk and detected these drugs in a triple quadrupole mass spectrometer with positive electrospray ionization. The validated concentration ranges (ng/mL) for zidovudine, lamivudine, lopinavir, and ritonavir were 12.5-750, 50-2500, 100-5000 and 5 to 250, respectively. Additionally, the absolute recovery percentages (and matrix effects) were 91.4 (8.39), 88.78 (28.75), 91.38 (11.77) and 89.78 (12.37), respectively. We determined that ARV drugs are stable for 24 h at 8°C and 24°C for 15 days at -80°C. This methodology had the capacity for simultaneous detection; separation; and accurate, precise quantification of ARV drugs in human breast milk samples according to Mexican standard laws and United States Food and Drug Administration guidelines.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/análise
Terapia Antirretroviral de Alta Atividade
Infecções por HIV/complicações
Infecções por HIV/tratamento farmacológico
Leite Humano/química
Complicações Infecciosas na Gravidez/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/normas
Aleitamento Materno
Calibragem
Cromatografia Líquida de Alta Pressão/métodos
Cromatografia Líquida de Alta Pressão/normas
Colostro/química
Feminino
Infecções por HIV/prevenção & controle
Seres Humanos
Recém-Nascido
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Lamivudina/análise
Lopinavir/análise
Gravidez
Complicações Infecciosas na Gravidez/metabolismo
Padrões de Referência
Reprodutibilidade dos Testes
Ritonavir/análise
Espectrometria de Massas em Tandem/métodos
Espectrometria de Massas em Tandem/normas
Adulto Jovem
Zidovudina/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anti-HIV Agents); 2494G1JF75 (Lopinavir); 2T8Q726O95 (Lamivudine); 4B9XT59T7S (Zidovudine); O3J8G9O825 (Ritonavir)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191236



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