HIV and maternal mortality: turning the tide

Karim, Quarraisha Abdool; AbouZahr, Carla; Dehne, Karl L.; Mangiaterra, Viviana; Moodley, J.; Rollins, Nigel; Say, Lale; Schaffer, Nathan; Rosen, James E.; Zoysa, Isabelle de

doi:10.1016/s0140-6736(10)60747-7

Cited by 58 publications

(53 citation statements)

References 13 publications

(11 reference statements)

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“…A key question pertains to the underlying cause of these HIV‐related maternal deaths. Sepsis and other infections secondary to compromised immunity could be responsible 6. In the South African series, 53% (2102/3959) of maternal deaths were due to infection, with 28% of these attributed to pregnancy‐related sepsis, often post‐partum, and 72% to non‐pregnancy‐related infections such as pneumonia and tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Mandala

Gondwe

Molyneux

et al. 2017

American J Rep Immunol

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ProblemWe investigated leukocyte and lymphocyte subsets in HIV‐infected or HIV‐uninfected, pregnant or non‐pregnant Malawian women to explore whether HIV infection and pregnancy may act synergistically to impair cellular immunity.Method of studyWe recruited 54 pregnant and 48 non‐pregnant HIV‐uninfected women and 24 pregnant and 20 non‐pregnant HIV‐infected Malawian women. We compared peripheral blood leukocyte and lymphocyte subsets between women in the four groups.ResultsParturient HIV‐infected and HIV‐uninfected women had more neutrophils (each P<.0001), but fewer lymphocytes (P<.0001; P=.0014) than non‐pregnant women. Both groups had fewer total T cells (P<.0001; P=.002) and CD8+ T cells (P<.0001; P=.014) than non‐pregnant women. HIV‐uninfected parturient women had fewer CD4+ and γδ T cells, B and NK cells (each P<.0001) than non‐pregnant women. Lymphocyte subset percentages were not affected by pregnancy.ConclusionMalawian women at parturition have an increased total white cell count due to neutrophilia and an HIV‐unrelated pan‐lymphopenia.

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Section: Introductionmentioning

confidence: 99%

Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Mandala

Gondwe

Molyneux

et al. 2017

American J Rep Immunol

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“…It should be noted that 6 out of the 12 women (50%) had begun their ART. The presence of opportunistic infections, such as pulmonary tuberculosis and neurotoxoplasmosis, and 2 results of T CD4+ lymphocyte lower than 350 cells/mm 3 were also detected, though they were related to the commitment of the clinical state during or after pregnancy.…”

Section: Resultsmentioning

confidence: 99%

“…aids, among other emerging infectious diseases, stands out due to its magnitude and extended damage toward population 2 . Many sub-Saharan countries have coexisting elevated maternal mortality and high HIV prevalence, among women in reproductive age, representing the two main causes of death among young women [3][4][5] . Worldwide, it is estimated that 2.6% maternal deaths are related to HIV-aids 1 .…”

Section: Introductionmentioning

confidence: 99%

“…Worldwide, it is estimated that 2.6% maternal deaths are related to HIV-aids 1 . Therefore, there is a risk of death due to the progression of HIV as well as due to complication related to pregnancy 3,6 . In Pernambuco, notifications and investigations of these cases have shown deaths of women in pregnancy and childbirth, often difficult to be classified as deaths by aids or women's death by HIV-aids.…”

Section: Introductionmentioning

confidence: 99%

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Classificação de óbitos em mulheres com vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida no ciclo gravídico-puerperal

Brayner

Alves

2017

Rev. bras. epidemiol.

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ABSTRACT:Objective: To reclassify deaths of women infected with the human immunodeficiency virus/ acquired immunodeficiency syndrome in pregnancy and childbirth in the State of Pernambuco, Brazil, from 2000 to 2010. Methods: A descriptive exploratory study, developed from the following steps: translation to Portuguese of the item "HIV and aids" of the United Nations document "The WHO application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: DCI MM 2012"; development of a classification algorithm of deaths of women living with the human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth; and reclassification of deaths by a group of experts. Results: Among the 25 reclassified deaths, 12 were due to human immunodeficiency virus/acquired immunodeficiency syndrome, and pregnancy condition was coexisting; 9 were reclassified as indirect maternal death, with O98.7 code, proposed by the World Health Organization; 2 as direct/indirect maternal death; and 2 were considered indeterminate. Conclusion: The reclassification showed a possible pattern of change in maternal mortality, since most of the deaths were attributed to the virus and may lead to a reduction in deaths from maternal causes. The algorithm will subsidize the use of the new classification of maternal death and human immunodeficiency virus/acquired immunodeficiency syndrome.

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“…1 The body of evidence on HIV and maternal mortality and morbidity is growing, but developing a better understanding of this relationship will require both additional research and more effective ways of recording and tracking adverse outcomes. 29,[80][81][82][83] Given the potential risks associated with HIV and pregnancy, ensuring comprehensive pregnancy care for HIV-positive women is essential. There is limited evidence on best practices for safe motherhood in the context of HIV.…”

Section: Achieving Safer Conceptionmentioning

confidence: 99%

How the global call for elimination of pediatric HIV can support HIV-positive women to achieve their pregnancy intentions

Mazzeo¹,

Flanagan

Bobrow

et al. 2012

Reproductive Health Matters

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HIV and maternal mortality: turning the tide

Cited by 58 publications

References 13 publications

Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Classificação de óbitos em mulheres com vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida no ciclo gravídico-puerperal

How the global call for elimination of pediatric HIV can support HIV-positive women to achieve their pregnancy intentions

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