From biology to sexual behaviour — towards the prevention of mother-to-child transmission of HIV

Bulterys, Marc; Goedert, James J.

doi:10.1097/00002030-199609000-00016

Cited by 14 publications

(5 citation statements)

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“…There are several plausible mechanisms by which increased sexual activity may increase MTCT. Increased sexual activity, particularly in populations with high HIV-1 seroprevalence, may be associated with increased strain diversity in the mother [65,151,[185][186][187]. Several studies have found that women infected with specific HIV-1 subtypes and recombinant viruses may be at increased risk of transmitting the virus to their infant [188][189][190].…”

Section: Sexual Activitymentioning

confidence: 99%

Host Factors that Influence Mother-to-Child Transmission of HIV-1: Genetics, Coinfections, Behavior and Nutrition

Ellington

King

Kourtis³

2011

Future Virol.

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Mother-to-child transmission (MTCT) is the most important mode of HIV-1 acquisition among infants and children and it can occur , intrapartum and postnatally through breastfeeding. Great progress has been made in preventing MTCT through use of antiretroviral regimens during gestation, labor/delivery and breastfeeding. The mechanisms of MTCT, however, are multifactorial and remain incompletely understood. This review focuses on select host factors affecting MTCT, in particular genetic factors, coexisting infections, behavioral factors and nutrition. Whereas much emphasis has been placed on decreasing maternal HIV-1 viral load, an important determinant of MTCT, through use of antiretroviral agents, complementary focus on overall maternal health is often neglected. By addressing coinfections in mothers and infants, improving the mother's nutritional status and modifying risky behaviors and practices, not only is maternal and child health improved, but a direct benefit in reducing MTCT can be derived. The study of genetic variations in susceptibility to HIV-1 infection is rapidly evolving, and the future is likely to bring revolutionary changes in HIV-1 prevention by enhancing natural resistance to infection and by individually tailoring pharmacologic regimens.

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Section: Sexual Activitymentioning

confidence: 99%

Host Factors that Influence Mother-to-Child Transmission of HIV-1: Genetics, Coinfections, Behavior and Nutrition

Ellington

King

Kourtis³

2011

Future Virol.

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“…Others include vaginal delivery process and prematurity of low birth weight of the neonate (Bryson, 1996;John and Kreiss, 1996;Lambert, 1996). High frequency of sexual activity and ''hard'' drug injection during pregnancy had previously been identified, along with unprotected sexual intercourse during pregnancy as certain behavioural risk factors for mother-to-child-transmission (Bulterys et al, 1997;Bulterys and Goedert, 1996). Firstly, unprotected intercourse might increase the concentration of strain diversity of HIV-1, particularly in the birth canal where ejaculated virus could be partially sequestered.…”

Section: Risk Factors For Vertical Transmission Of Hivmentioning

confidence: 99%

“…Secondly, frequent intercourse might increase inflammation of the cervix or vagina either micro abrasion or if unprotected, by STDs. Third, frequent intercourse might increase the risk of chorioamnionitis or otherwise alter the integrity of the placenta (Bulterys and Goedert, 1996). Matheson et al (1997) found that continued drug users had significantly higher mother-to-child-transmission rates in maternal drug use during pregnancy.…”

Section: Risk Factors For Vertical Transmission Of Hivmentioning

confidence: 99%

Human Immunodeficiency Virus Transmission

Nanjul¹

2011

Global View of HIV Infection

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“…65 In addition to strain diversity, two other mechanisms could explain the increased perinatal transmission associated with heterosexual behavior during pregnancy. 66 First, inflammation of the vagina and cervix could be increased with frequent intercourse either by microabrasions or through STDs when intercourse was not protected. Second, frequent intercourse might increase the risk of chorioamnionitis or affect the integrity of the placenta.…”

Section: Role Of Selected Factors Associated With Mtct Of Hiv and Gtismentioning

confidence: 99%

Genital Tract Infections and Perinatal Transmission of HIV

Taha

Gray

2000

Annals of the New York Academy of Sciences

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In areas of the world where genital tract infections (GTIs) are common, the prevalence of HIV and the rate of mother‐to‐child transmission (MTCT) of HIV are also high. Although observational studies suggested that GTIs are associated with MTCT of HIV, no controlled clinical trial has confirmed this finding. It is likely that GTIs that cause either discharges or ulcers during pregnancy increase perinatal transmission of HIV. Several potential biological mechanisms might facilitate perinatal transmission. For example, chorioamnionitis, increased viral shedding in cervicovaginal secretions, increased HIV acquisition during pregnancy, inflammatory cytokine production, preterm labor, prolonged rupture of membranes, ascending infection, and increased intrapartum infectious secretions are factors that can be associated with GTIs. Several studies have shown that treating clinical conditions associated with inflammation might alter HIV shedding. It is conceivable that preventing ascending infection or reducing exposure of the infant to infectious material during birth could reduce MTCT. This can possibly be achieved by antimicrobial therapy during pregnancy and intrapartum. Such an approach is practical, is less expensive, and has secondary benefits related to prevention of adverse pregnancy outcomes associated with GTIs. Antibiotics might also complement reductions in MTCT of HIV obtained by antiretrovirals given to the mother around the time of delivery. In addition, antibiotics could reduce infectious causes of morbidity and mortality in infant and mother.

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From biology to sexual behaviour — towards the prevention of mother-to-child transmission of HIV

Cited by 14 publications

References 0 publications

Host Factors that Influence Mother-to-Child Transmission of HIV-1: Genetics, Coinfections, Behavior and Nutrition

Host Factors that Influence Mother-to-Child Transmission of HIV-1: Genetics, Coinfections, Behavior and Nutrition

Human Immunodeficiency Virus Transmission

Genital Tract Infections and Perinatal Transmission of HIV

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