BackgroundAntiretroviral therapy (ART) use in pregnancy presents unquestionable benefits in preventing mother-to-child transmission (MTCT) of HIV although it is associated with maternal adverse effects. The aim of this study was to evaluate the adverse effects of antiretroviral therapy in pregnant women infected with HIV.MethodsCohort study of pregnant women infected with HIV followed at the CAISM/UNICAMP Obstetric Clinic from 2000 to 2015. The following maternal adverse effects were observed: anemia, thrombocytopenia, allergy, liver function test abnormalities, dyslipidemia and diabetes. Data collected from patients’ files was added to a specific database. Descriptive analysis was shown in terms of absolute (n) and relative (%) frequencies and mean, median and standard deviation calculations. Chi-square or Fisher exact test (n < 5) and relative risk (RR) with its respective p values were used for categorical variables and Student t-test (parametric data) or Mann-Whitney (non-parametric data) for the quantitative ones. A 95% confidence interval (CI) and a significant level of 0.05 were used. A multivariate Cox Logistic Regression was also done. Data analysis was conducted using SAS version 9.4.ResultsData from 793 pregnancies were included. MTCT rate was 2.3%, with 0.8% in the last 5 years. Maternal adverse effects were: dyslipidemia (82%), anemia (56%), liver function test abnormalities (54.5%), including hyperbilirubinemia (11.6%), fasting glycemia alteration (19.2%), thrombocytopenia (14.1%), and allergic reaction (2.7%). The majority of adverse effects deemed related to ART in this study were mild according to DAIDS scale. In the multivariate analysis, co-infections and starting ART during pregnancy were risk factors for maternal anemia, while CD4 count higher than 200 cells/mm3 was protective. Nevirapine, nelfinavir and atazanavir regimens increased the risk for liver function tests abnormalities. Lopinavir use during pregnancy increased the risk for fasting glycemia alteration.ConclusionThe evolution of the national guidelines of antiretroviral therapy for pregnant women improved adherence to the treatment and resulted in a significant reduction of MTCT. Despite the high frequency of maternal adverse effects, they are mostly of low severity. Newer ART medications with improved efficacy and significantly more favorable tolerability profiles should reduce the incidence of ART-related adverse effects.
The purpose of this paper is to report the occurrence in our Clinic of a pregnancy and term delivery, obtained from oocytes proceeding from very small diameter follicles.
IntroductionSignificant progress of ART in HIV infection has led to a remarkable decline in mother-to-child transmission (MTCT) of HIV. However, the use of complex regimens can cause side effects to women and exposed children.The objective of this study was to evaluate side effects in pregnant women and their neonates exposed to ART at an universitary hospital in Brazil between 2000 and 2016.MethodsCohort study of 793 pregnant women and 787 newborns selected from clinical records and epidemiologic surveillance system. Analysis was performed through proportions and medians. The specific effect of different ART regimens was analysed through risk ratios (RR), qui-square test, Fisher’s exact test, student t test, Mann-Whitney test, 95% confidence interval and level of significance of 0.05.ResultsMTCT rate was 2.3%. Mean age was 28 years, more than 60% were White and diagnosed before pregnancy. HAART use: 17.4% with nevirapine (NVP), 16.9% with nelfinavir (NFV), 53.2% with lopinavir/ritonavir (LPV/R), 4.3% with other PI (26 with atazanavir/ritonavir). Only 1.9% women did not use ART by late diagnosis. There were: 56% cases of maternal anaemia,14.1% of thrombocytopenia, 54.5% of hepatic abnormalities, 2.7% of allergic reactions, 82% of dyslipidemia, 6.2% of diabetes. NVP use was associated to hepatotoxicity, allergic reactions and anaemia. NFV was associated to hepatic impairment and allergic reaction, ATV/R use was associated to bilirrubin increase, and LPV/R to dyslipidemia.Prematurity rate was 21.7% and low birth weight rate 22.5%. In the newborns: 25.7% of anaemia, 3.6% of thrombocytopenia, 36% of hepatic impairment. Congenital anomalies were presented in 10%. NVP use associated to anaemia and hepatic impairment. NFV was associated to hepatic abnormalities. ATV/R was associated to thrombocytopenia.ConclusionAlthough growing evidence indicates that antiretroviral treatment in pregnancy has overall a very favourable risk-benefit profile, it is important to maintain monitoring of the safety and efficacy of drug classes in order to optimise treatment recommendations.
Introdução: IST ainda é um importante problema de saúde nas mulheres. Objetivo: Avaliar características clínicas e epidemiológicas das infecções sexualmente transmissíveis em mulheres militares e familiares de militares no âmbito da Guarnição Militar de Campinas (SP), comparando com os dados do Ministério da Saúde e dos levantamentos em exércitos de outras nações. Métodos: Estudo de coorte retrospectivo de 1.019 mulheres da Guarnição Militar de Campinas atendidas no PMGu/Cas no período de 2017 a 2020. Foram analisadas as 1.019 mulheres, sendo excluídas 372 de acordo com os critérios de exclusão. Análise dos dados: análise descritiva por meio de distribuição percentual e de médias e teste de χ², razão de risco e intervalo de confiança. Resultados: Das 647 mulheres consideradas, foram encontradas 119 mulheres com alguma infecção sexualmente transmissível. No grupo de infectadas, a idade média foi de 32 anos; nas não infectadas, foi de 39 anos. Das 119 infectadas, 74 já tinham diagnóstico prévio ou foram diagnosticadas clinicamente e 45 mulheres tiveram seu diagnóstico efetivado após o resultado dos exames colhidos pois eram assintomáticas. A queixa mais frequente nessa população era de corrimento vaginal (99 mulheres), mas apenas 35 estavam também no grupo que apresentava alguma infecção sexualmente transmissível. A suspeição para doença inflamatória pélvica aguda ocorreu em 38 mulheres e, dessas, apenas 12 apresentaram alguma infecção sexualmente transmissível bacteriana contra 23 infecções sexualmente transmissíveis virais. Conclusão: Nessa coorte, a presença de corrimento genital não apresentou relação com a presença de infecções sexualmente transmissíveis. Em nosso grupo de pacientes, houve maior ocorrência de suspeição de doença inflamatória pélvica aguda concomitante a infecções sexualmente transmissíveis viral em vez de infecções sexualmente transmissíveis bacterianas. A proporção de Neisseria encontrada em relação a clamídia foi de 1:2, e cerca de 80% dos casos diagnosticados de papilomavírus humano eram assintomáticos. Do total, 11,76% das infecções sexualmente transmissíveis encontradas eram curáveis, ficando 20% abaixo da média nacional para esse mesmo tipo de doença.
BACKGROUND: Given the characteristics of military missions, intense interpersonal contact, and wide variation in casual relationships, the military has long been recognized as a high-risk population for sexually transmitted infections (STIs). OBJECTIVE: To assess the prevalence of STIs and socioepidemiological profile of women in the military garrison of Campinas. DESIGN AND SETTING: This prospective, cross-sectional epidemiological study, assisted by the Health Fund in the military garrison of Campinas, assessed the prevalence of human immunodeficiency virus (HIV), hepatitis B and C, syphilis, human papillomavirus (HPV), chlamydia, and gonococcus in military women or companions of soldiers with active or previously active sexual life. METHODS: This study included 647 women based on the non-inclusion criteria. They underwent clinical and laboratory tests for diagnosis of STIs. For statistical analysis, patients were divided into groups according to the presence or absence of STIs and into age groups. RESULTS: Most women were military dependents, and the majority were asymptomatic. The prevalence of STIs, in ascending order, was 0.3% for hepatitis B and C, 0.62% for syphilis, 0.62% for gonorrhea, 1.08% for chlamydia, and 2.63% for HPV. There were no cases of HIV infection. CONCLUSIONS: The Brazilian Army has the most women-like dependents in the military, belonging to the hierarchical circle of the squares. Early onset of sexual activity favored STIs approximately twice, and younger women had approximately seven times more chlamydia infections. In the general population studied, the prevalence of STIs was lower than expected than in the armed forces of other nations.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.