HIV-1: maternal prognosis

Beitune, Patrícia El; Duarte, Geraldo; Quintana, Silvana Maria; Croy, B. Anne

doi:10.1590/s0041-87812004000100005

Cited by 9 publications

(3 citation statements)

References 75 publications

(86 reference statements)

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“…In some regions, the gender ratio of infection is already one man to one woman. Consequently, pediatric infection from mother-to-child transmission is the most common route of HIV infection among Brazilian children, although the prevalence of HIV infection among pregnant women in Brazil is less than 1% [2][3].…”

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Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil

Cremonezi¹,

Mesquita²,

Romão

et al. 2005

Braz J Infect Dis

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The AIDS epidemic is spreading rapidly among women worldwide, offering increasing opportunities for vertical transmission of HIV. In Brazil, the prevalence of HIV infection among pregnant women is less than 1%. Therefore, the positive predictive value of an HIV EIA test tends to be lower than the more frequent indeterminate Western blot result. Pregnant women receiving antenatal care, from 2000 to 2004, at a public secondary hospital in the city of Presidente Prudente, São Paulo, Brazil, were systematically screened for HIV by means of two distinct EIA tests, in order to determine the prevalence of indeterminate Western blot results among pregnant women showing discordance in both HIV EIA tests and indirect immunofluorescence assay. Confirmatory indirect immunofluorescence was performed on material for all women with positive results in both EIA tests. Whenever there were positive results in EIA and IIA, the applicant was retested by the initial screening assay. Only those not showing concordance in results in EIA and IAA had a Western blot performed. The viral load was measured in pregnant women with positive or indeterminate Western blot results. Out of 9,786 sera, 105 (1.0%) were positive in the two HIV EIA screening tests, confirmed by indirect immunofluorescence. Among these women, Western blot was interpreted as indeterminate in 11 (0.1%) cases and their viral load was <50 copies/mL. We found a prevalence of 0.1% HIV indeterminate Western blots in pregnant women from Presidente Prudente and the surrounding region; none of these pregnant women had positive HIV viral loads.

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confidence: 99%

Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil

Cremonezi¹,

Mesquita²,

Romão

et al. 2005

Braz J Infect Dis

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“…Additionally, as long as the mother is in good health, HIV does not impact the course of the pregnancy [ 12 ]. The risks of complications are higher for the mother and her fetus when mother develops an HIV-related opportunistic disease and when the CD4 cells count is below 200/µl [ 13 ]. Miscarriages, abortions, ectopic pregnancies and stillborns delivery seem to be as recurrent among HIV positive women (some of whom were under ART) as among non infected women [ 8 , 14 – 16 ].…”

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confidence: 99%

Pregnancy rate and birth outcomes among women receiving antiretroviral therapy in Burkina Faso: a retrospective cohort study

Poda¹,

Hema²,

Konaté³

et al. 2016

Pan Afr Med J

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IntroductionIn Sub-Saharan Africa, few studies reported pregnancy incidence and outcomes in women taking antiretroviral therapy (ART). This survey aims to estimate the incidence and outcomes of pregnancy in a cohort of HIV positive women initiating ART in Bobo-Dioulasso, Burkina Faso.MethodsWe carried out a retrospective cohort study. We selected women in childbearing age initiating ART and followed up in Bobo-Dioulasso teaching hospital between January 2005 and June 2011. The incidence of pregnancies during follow-up was calculated. Childbirth was defined by the expulsion of a fetus after 22 weeks of amenorrhea. Before this term, it is an abortion. Childbirth is said premature if it occurs before 37 weeks of gestation, to term if it occurs between the 38th and the 42nd week. The annual age-standardized fertility rates were calculated using the baseline population from the 2010 demographic and health survey (DHS) in Burkina Faso.ResultsA total of 1,763 women of childbearing age under ART were included in the study. They ranged between 18 and 48 years old with a median of 35 years old. A total of 222 pregnancies were observed during 4639 women-years of follow-up, corresponding to an incidence density of 5 pregnancies for 100 women-years (95% CI: 4.2-5.5). Among the 222 pregnancies recorded, 9(4.0%) ended with abortion, 205(92.4%) with childbirth (including 15 premature childbirths); the outcome of 8(3.6%) pregnancies were unknown abortion. Live birth and stillborn rates were 94.0% (193/205) and 6.0% respectively. The standard fertility rate in our cohort was 45 live births for 1,000 women-years. The general decrease in fertility rates was 66.0% among women infected with HIV compared to the overall populationConclusionThis study shows a low pregnancy incidence among women initiating ART as compared to their peers from the general population. Pregnancies that occurred during ART generally end with live births. Care packages for HIV infected women of childbearing age must include reproductive health services to better address this issue.

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“…1 However, the improved quality of life and survival of HIV-1-infected patients, together with the significant reduction of vertical transmission obtained after a better understanding of the pathogenesis and risk factors for the disease and after the introduction of powerful antiretroviral (ARV) medications, has eliminated the condition of HIV-1 infection as an insurmountable obstacle regarding maternity. 2 Antiretroviral compounds differ from most other new pharmaceutical agents in that they have become widely prescribed in pregnancy in the absence of proof of safety. 3 Combinations of 3 or more compounds are recommended when treatment of the mother is deemed necessary because of advanced HIV infection.…”

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Effect of Antiretroviral Drugs on Maternal Cd4 Lymphocyte Counts, Hiv-1 Rna Levels, and Anthropometric Parameters of Their Neonates

Beitune

Duarte

Machado

et al. 2005

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PURPOSE: To study the effect of antiretroviral drugs administered during pregnancy on CD 4 lymphocyte counts and HIV-1 RNA levels of pregnant women and on the anthropometric parameters of their neonates. METHODS: A prospective study was conducted on 57 pregnant women and their neonates divided into 3 groups: ZDV Group, HIV-infected mothers taking zidovudine (n = 20); triple therapy (TT) Group, mothers taking zidovudine + lamivudine + nelfinavir (n = 25), and Control Group, normal women (n = 12). CD 4 lymphocyte counts and HIV-1 RNA levels of pregnant women were analyzed during two periods of pregnancy. The perinatal prognosis took into account preterm rates, birth weight, intrauterine growth restriction, perinatal death, and vertical transmission of HIV-1. Data were analyzed statistically using the nonparametric chi-square, Mann-Whitney, Friedman, Kruskal-Wallis, and Wilcoxon matched pairs tests, with the level of significance set at P <.05. RESULTS: The major maternal demographic and anthropometric data were homogeneous for the various groups. HIV-1 viral burden, which was initially elevated, median of 14,370 copies/mL, was significantly reduced in the TT group, reaching 40 copies/mL. With respect to T-CD 4 + lymphocyte counts, there was a significant recovery in Group TT at the end of pregnancy, this value being significantly different from that for the ZDV group (P =.0052). There was no difference between groups regarding gestation length, Apgar scores, or neonatal anthropometric classification. There was no case of vertical HIV-1 transmission. CONCLUSIONS: The results obtained for the present series demonstrate the efficiency and suggest safety of the use of antiretroviral drugs during pregnancy as revealed by anthropometric parameters of the neonate.

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HIV-1: maternal prognosis

Cited by 9 publications

References 75 publications

Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil

Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil

Pregnancy rate and birth outcomes among women receiving antiretroviral therapy in Burkina Faso: a retrospective cohort study

Effect of Antiretroviral Drugs on Maternal Cd4 Lymphocyte Counts, Hiv-1 Rna Levels, and Anthropometric Parameters of Their Neonates

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