Eliminating postnatal HIV transmission in high incidence areas: need for complementary biomedical interventions

Perre, Philippe Van de; Goga, Ameena; Ngandu, Nobubelo K.; Nagot, Nicolas; Moodley, Dhayendre; King, Rachel; Molès, Jean‐Pierre; Mosqueira, Beatriz; Chirinda, Witness; Scarlatti, Gabriella; Tylleskär, Thorkild; Dabis, François; Gray, Glenda

doi:10.1016/s0140-6736(21)00570-5

Cited by 31 publications

(32 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have previously highlighted the increasing contribution of breast milk transmission to overall mother-to-child transmission in low and middle income countries because of challenges with early initiation of antiretroviral treatment and postnatal treatment adherence 19. We have also highlighted the contribution of maternal prevalent or incident HIV infections to the paediatric HIV case rate161920 and proposed that current strategies may fall short of eliminating breast milk transmission 19. Complementary interventions such as broadly neutralising antibodies or vaccines are needed 19.…”

mentioning

confidence: 99%

“…We have also highlighted the contribution of maternal prevalent or incident HIV infections to the paediatric HIV case rate161920 and proposed that current strategies may fall short of eliminating breast milk transmission 19. Complementary interventions such as broadly neutralising antibodies or vaccines are needed 19. We have also emphasised the critical need to dismantle structural barriers16 and strengthen routine cohort monitoring of women living with HIV and their children to determine long term outcomes 21.…”

mentioning

confidence: 99%

“…19 Complementary interventions such as broadly neutralising antibodies or vaccines are needed. 19 We have also emphasised the critical need to dismantle structural barriers 16 and strengthen routine cohort monitoring of women living with HIV and their children to determine long term outcomes. 21 Here we consider whether we can eliminate breast milk transmission of HIV in women taking antiretroviral drugs.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Eliminating HIV transmission through breast milk from women taking antiretroviral drugs

Goga

Perre

Ngandu

et al. 2021

BMJ

Self Cite

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Eliminating HIV transmission through breast milk from women taking antiretroviral drugs

Goga

Perre

Ngandu

et al. 2021

BMJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…Approximately 70% of people living with HIV are in Sub-Saharan Africa. Effective treatment with antiretroviral therapy (ART) besides prevention of new infections among key populations have helped in the fight against the HIV/AIDS pandemic [13][14][15][16]. However, only 68% of HIV-infected individuals were accessing antiretroviral therapy as of the end of June 2020 [11].…”

Section: Introductionmentioning

confidence: 99%

Expression of Chimeric HPV-HIV Protein L1P18 in Pichia pastoris; Purification and Characterization of the Virus-like Particles

et al. 2021

View full text Add to dashboard Cite

Currently, three human papillomavirus (HPV) vaccines are already licensed and all of them are based on virus-like particles (VLPs) of HPV L1 capsid protein but not worldwide accessible. While about 38.0 million people were living with HIV in 2019, only 68% of HIV-infected individuals were accessing antiretroviral therapy as of the end of June 2020 and there is no HIV vaccine yet. Therefore, safe, effective, and affordable vaccines against those two viruses are immediately needed. Both HPV and HIV are sexually transmitted infections and one of the main access routes is the mucosal genital tract. Thus, the development of a combined vaccine that would protect against HPV and HIV infections is a logical effort in the fight against these two major global pathogens. In this study, a recombinant Pichia pastoris producing chimeric HPV-HIV L1P18 protein intracellularly was constructed. After cell disruption, the supernatant was collected, and the VLPs were purified by a combination of ammonium sulfate precipitation, size exclusion chromatography, ultracentrifugation, and ultrafiltration. At the end of purification process, the chimeric VLPs were recovered with 96% purity and 9.23% overall yield, and the morphology of VLPs were confirmed by transmission electron microscopy. This work contributes towards the development of an alternative platform for production of a bivalent vaccine against HPV and HIV in P. pastoris.

show abstract

“…With adequate adherence, oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, is safe and feasible for use in PBFW without HIV to prevent HIV acquisition during pregnancy and the postpartum period. 5 Despite its potential value for HIV prevention, PrEP adherence is low in many settings, 6-10 including in PBFW 11 .…”

Section: Introductionmentioning

confidence: 99%

Pre-exposure prophylaxis adherence with real-time adherence feedback and partner HIV self-testing: A pilot trial among postpartum women

Davey

Dovel

Mvududu

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Pre-exposure prophylaxis (PrEP) is safe and effective in postpartum women. HIV self-testing (HIVST) for partners combined with biofeedback counselling through real-time adherence measures may improve daily PrEP use among postpartum women. Methods: Between August 2020 and April 2021 we conducted a pilot study in one primary care clinic in Cape Town, South Africa. We randomized postpartum women who initiated PrEP in pregnancy 1:1 to the intervention group (HIVST + biofeedback counselling following urine tenofovir test) or to standard of care (facility-based HIV tests and routine counselling without biofeedback). The outcomes of interest were PrEP adherence in the past 48-72hours via urine tenofovir tests and partner HIV testing, measured 1-month after randomisation. Secondary outcomes included proportion of partners who tested for HIV and discrepancy between self-reported PrEP adherence and urine tenofovir result. Results: We enrolled 106 women (median age=26 years; median months postpartum=2). Almost half of women reported having sex since giving birth (48%); 76% of those reported condomless sex at last sex. At enrolment most women (72%) reported missing <2 doses in the past 7-days; 36% of women had tenofovir present in her urine (no significant differences by arm). One month after enrolment, 62% (n=33) of women in the intervention arm had tenofovir present in their urine compared to 34% (n=18) in the standard of care arm (RR=1.83; 95% CI=1.19, 2.82). Two-thirds of women in the intervention arm reported that her partner tested for HIV (66%; n=35); compared to 17% (n=9) in the standard of care arm (RR=3.89; 95% CI=2.08, 7.27). The proportion of women with a discrepant adherence result (self-reported good recent adherence with no tenofovir in urine test) was significantly lower in the intervention group (n=8; 17%) compared to the standard of care group (n=24; 46%) (RR=0.33; 95% CI=0.17, 0.67). No social or clinical adverse events were reported in the intervention arm. Conclusions: In this pilot study, HIVST for partners and biofeedback counseling increased levels of recent PrEP adherence, pointing to the importance of these interventions to support PrEP use in this population.

show abstract

Eliminating postnatal HIV transmission in high incidence areas: need for complementary biomedical interventions

Cited by 31 publications

References 72 publications

Eliminating HIV transmission through breast milk from women taking antiretroviral drugs

Eliminating HIV transmission through breast milk from women taking antiretroviral drugs

Expression of Chimeric HPV-HIV Protein L1P18 in Pichia pastoris; Purification and Characterization of the Virus-like Particles

Pre-exposure prophylaxis adherence with real-time adherence feedback and partner HIV self-testing: A pilot trial among postpartum women

Contact Info

Product

Resources

About