Contemporary Issues in Pregnancy (and Offspring) in the Current HIV Era

Eckard, Allison Ross; Kirk, Stephanie; Hagood, Nancy L

doi:10.1007/s11904-019-00465-2

Cited by 14 publications

(12 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 196 Infants born from HIV-positive women are at higher risk of intrauterine FGR and low-birth weight 203 , 204 ; however, it is difficult to discern the effects directly caused by HIV from those caused by opportunistic infections and antiretroviral therapy. 205 – 208 …”

Section: Major Infections During Pregnancy: Torch (Toxoplasmosis Other Agents Rubella Cytomegalovirus Herpes Simplex)mentioning

confidence: 99%

Maternal natural killer cells at the intersection between reproduction and mucosal immunity

Shmeleva

Colucci

2021

Mucosal Immunology

View full text Add to dashboard Cite

Many maternal immune cells populate the decidua, which is the mucosal lining of the uterus transformed during pregnancy. Here, abundant natural killer (NK) cells and macrophages help the uterine vasculature adapt to fetal demands for gas and nutrients, thereby supporting fetal growth. Fetal trophoblast cells budding off the forming placenta and invading deep into maternal tissues come into contact with these and other immune cells. Besides their homeostatic functions, decidual NK cells can respond to pathogens during infection, but in doing so, they may become conflicted between destroying the invader and sustaining fetoplacental growth. We review how maternal NK cells balance their double duty both in the local microenvironment of the uterus and systemically, during toxoplasmosis, influenza, cytomegalovirus, malaria and other infections that threat pregnancy. We also discuss recent developments in the understanding of NK-cell responses to SARS-Cov-2 infection and the possible dangers of COVID-19 during pregnancy.

show abstract

Section: Major Infections During Pregnancy: Torch (Toxoplasmosis Other Agents Rubella Cytomegalovirus Herpes Simplex)mentioning

confidence: 99%

Maternal natural killer cells at the intersection between reproduction and mucosal immunity

Shmeleva

Colucci

2021

Mucosal Immunology

View full text Add to dashboard Cite

show abstract

“…These adverse effects include mitochondrial dysfunction, most often observed in laboratory abnormalities seizures, cognitive and motor delays, cardiac dysfunction, and slower earlier growth [ 12 , 14 ]. In assessing neuropsychological development, HIV exposed infants had lower neurodevelopmental outcomes than their unexposed counterparts, even when controlling for confounders such as poverty, nutritional status, and maternal education, which are known to negatively influence these outcomes [ 12 ]. HIV exposed infants assessed with the Bayley Scales of development at 25 months showed inferior receptive language, social-emotional and self-regulatory skills [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…These pathways include direct exposure to the neurotropic HIV-virus, the effects of maternal inflammation and immune activation in-utero, immune activation and inflammation in the exposed fetus, which all influence brain development, and ART toxicity [11]. Evidence from multiple studies indicates the adverse effects experienced by these infants in their early developmental years [12][13][14][15][16]. These adverse effects include mitochondrial dysfunction, most often observed in laboratory abnormalities seizures, cognitive and motor delays, cardiac dysfunction, and slower earlier growth [12,14].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence from multiple studies indicates the adverse effects experienced by these infants in their early developmental years [12][13][14][15][16]. These adverse effects include mitochondrial dysfunction, most often observed in laboratory abnormalities seizures, cognitive and motor delays, cardiac dysfunction, and slower earlier growth [12,14]. In assessing neuropsychological development, HIV exposed infants had lower neurodevelopmental outcomes than their unexposed counterparts, even when controlling for confounders such as poverty, nutritional status, and maternal education, which are known to negatively influence these outcomes [12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurobehavioural challenges experienced by HIV exposed infants: a study in South Africa

2022

View full text Add to dashboard Cite

Background The newborn infant is a complexly organized, competent being, who plays an active role in shaping their environment through their increasing skills in autonomic regulation, motor control, regulation of state and social interaction. Infants born to HIV positive mothers, are exposed to HIV and antiretroviral therapy inutero, and may experience adverse effects from this. Methods A cross-sectional study of 132 mother-infant dyads from a large public health hospital in South Africa. Infants were assessed using the Neonatal Behavioural Assessment Scale on day two of life, and mothers mental health assessed using the Edinburugh Postnatal Depression Scale. Medical and demographic data on mothers and infants was collected, including maternal age, HIV status, length of time on antiretrovirals, relationship status, employment status, gravid status, mode of delivery, infant anthropometrics and infant gender. Data was input into IBM SPSS statistics 21, where frequencies and percentages for descriptive analysis, and Chi-square and student’s two sample t-tests were run to compare data from HIV infected-exposed and HIV uninfected-unexposed mothers and infants. Results HIV exposed infants were smaller than HIV unexposed infants, even though low birth weight was an exclusion criteria. Statistically significant differences were found between HIV exposed and unexposed infants in neurobehavioiral items of social interaction (p = 0.00), motor system (p = 0.00) and state organization (p = 0.01), with HIV exposed infants performing less optimally in these domains. HIV exposed infants also presented with more abnormal reflexes. Infants born to depressed mothers showed superior motor skills, state organization and state regulation than infants born to mothers who did not score in the possibly depressed range. Conclusions HIV exposed infants have inferior neurobehavioural functioning, which may affect their quality of life and ability to develop a reciprocal relationship with a primary caregiver. This may have an effect on development, behaviour and mental health in later childhood. HIV exposed infants shoud be monitored closely and their functioning in autonomic stability, motor control, resualtion of state and social interaction assessed regularly. Guidance for caregivers in incorporating strategies into the care of these infants is essential to buffer the possible long term negative effects on development.

show abstract

“…In 2019, 15.2 million children were CHEU worldwide, thus exposed to HIV and ARV [ 6 ]. Many unfavourable health outcomes have been reported in CHEU such as metabolic disorders [ 7 , 8 ], increased infectious disease morbidity and higher mortality [ 9 , 10 , 11 , 12 ], impaired growth [ 13 , 14 , 15 , 16 , 17 , 18 ], neurodevelopmental delays [ 17 , 19 , 20 , 21 ], altered immunity [ 10 , 22 , 23 , 24 , 25 , 26 ], and mitochondrial toxicity in comparison to never HIV-exposed children [ 27 , 28 , 29 , 30 ]. Taken together, this prompted Powis and Siberry to advocate for the long-term follow up of CHEU irrespective of their HIV/ARV exposures [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial DNA Parameters in Blood of Infants Receiving Lopinavir/Ritonavir or Lamivudine Prophylaxis to Prevent Breastfeeding Transmission of HIV-1

Monnin

Nagot

Peries

et al. 2020

JCM

View full text Add to dashboard Cite

Children who are human immunodeficiency virus (HIV)-exposed but uninfected (CHEU) accumulate maternal HIV and antiretroviral exposures through pregnancy, postnatal prophylaxis, and breastfeeding. Here, we compared the dynamics of mitochondrial DNA (mtDNA) parameters in African breastfed CHEU receiving lopinavir/ritonavir (LPV/r) or lamivudine (3TC) pre-exposure prophylaxis during the first year of life. The number of mtDNA copies per cell (MCN) and the proportion of deleted mtDNA (MDD) were assessed at day 7 and at week 50 post-delivery (PrEP group). mtDNA depletion was defined as a 50% or more decrease from the initial value, and mtDNA deletions was the detection of mtDNA molecules with large DNA fragment loss. We also performed a sub-analysis with CHEU who did not receive a prophylactic treatment in South Africa (control group). From day seven to week 50, MCN decreased with a median of 41.7% (interquartile range, IQR: 12.1; 64.4) in the PrEP group. The proportion of children with mtDNA depletion was not significantly different between the two prophylactic regimens. Poisson regressions showed that LPV/r and 3TC were associated with mtDNA depletion (reference: control group; LPV/r: PR = 1.75 (CI95%: 1.15–2.68), p < 0.01; 3TC: PR = 1.54 (CI95%: 1.00–2.37), p = 0.05). Moreover, the proportion of children with MDD was unexpectedly high before randomisation in both groups. Long-term health impacts of these mitochondrial DNA parameters should be investigated further for both CHEU and HIV-infected children receiving LPV/r- or 3TC- based regimens.

show abstract

Contemporary Issues in Pregnancy (and Offspring) in the Current HIV Era

Cited by 14 publications

References 97 publications

Maternal natural killer cells at the intersection between reproduction and mucosal immunity

Maternal natural killer cells at the intersection between reproduction and mucosal immunity

Neurobehavioural challenges experienced by HIV exposed infants: a study in South Africa

Mitochondrial DNA Parameters in Blood of Infants Receiving Lopinavir/Ritonavir or Lamivudine Prophylaxis to Prevent Breastfeeding Transmission of HIV-1

Contact Info

Product

Resources

About