Interventions for reducing the risk of mother-to-child transmission of HIV infection

Abstract

Five infants were born to human immunodeficiency virus (HIV)-infected women from 2002 to 2006 in a regional hospital in Hong Kong. Four of the 5 women were residents in Mainland China. Among them, three women had no antenatal care and their first presentation to the local healthcare system was advanced labour at the Accident and Emergency Department. As a result, antenatal and intrapartum antiretroviral chemoprophylaxis was not given and postnatal chemoprophylaxis in the newborn was delayed. Three infants, including the two whose mothers' infection was diagnosed antenatally, were free of HIV infection. One child was eventually infected with HIV while the other child did not return for follow-up. Thus, the report suggests that the majority of infants at risk for perinatal HIV transmission are born by non-resident women, whose unique health-seeking behaviour undermines the efficacy of peripartum management to prevent mother-to-child transmission of HIV.

Impact of Maternal HIV Infection on Pregnancy and Labour Complication and Perinatal Health Outcomes: A South African Retrospective Study

“…Additionally, we demonstrate signi cantly shorter duration of active labour in women with HIV compared towomen without, both before and after the COVID-19 pandemic. Our ndings corroborate previous reports, which indicate that prolonged labour increases the risk of mother-to-child HIV transmission, HIV infected women typically have shorter active labour periods than uninfected women [40][41][42]. Current clinical management plans strive to reduce the duration of labour as a means to reduce foetal exposure to the virus through maternal blood and cervical secretions [40].…”

Impact of Maternal HIV Infection on Pregnancy and Labour Complication and Perinatal Health Outcomes: A South African Retrospective Study

“…Additionally, we demonstrate signi cantly shorter duration of active labour in women with HIV compared towomen without, both before and after the COVID-19 pandemic. Our ndings corroborate previous reports, which indicate that prolonged labour increases the risk of mother-to-child HIV transmission, HIV infected women typically have shorter active labour periods than uninfected women [40][41][42]. Current clinical management plans strive to reduce the duration of labour as a means to reduce foetal exposure to the virus through maternal blood and cervical secretions [40].…”

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

“…There was no evidence that ARV drugs affected the incidence of preterm delivery or increased low birth weight rates, Apgar scores, or fetal mortality. 18,19 In the present series, the resolution of pregnancy occurred after 38.5 weeks among the patients taking an ARV scheme containing a protease inhibitor, with no difference from the other groups, including the Control Group. These results are in accordance with those obtained in the PACTG 367, an observational study involving 1,472 HIV-1-infected pregnant women, 1,150 of them treated with a combined scheme, in which no association was observed between the use of these medications and preterm deliveries.…”

Determinants of Mother-to-Infant Human Immunodeficiency Virus 1 Transmission Before and After the Introduction of Zidovudine Prophylaxis

“…2,3 Guidelines for HIV-1-infected pregnant women recommend that zidovudine prophylaxis should be associated with combined ART 9 since, at present, only zidovudine and nevirapine therapies have been demonstrated to effectively prevent mother-toinfant transmission. 1,21 In our study, 95% of women receiving combined ART had zidovudine included in their regimen and/or as part of the other 2 parts of the PACTG 076 protocol. Whether perinatal HIV-1 transmission may be equally preventable by other combined antiretroviral regimens independent of whether zidovudine is included or not remains to be seen.…”

Impact of Maternal HIV Infection on Pregnancy and Labour Complication and Perinatal Health Outcomes: A South African Retrospective Study

“…Additionally, we demonstrate signi cantly shorter duration of active labour in women with HIV compared towomen without, both before and after the COVID-19 pandemic. Our ndings corroborate previous reports, which indicate that prolonged labour increases the risk of mother-to-child HIV transmission, HIV infected women typically have shorter active labour periods than uninfected women [40][41][42]. Current clinical management plans strive to reduce the duration of labour as a means to reduce foetal exposure to the virus through maternal blood and cervical secretions [40].…”

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

“…There was no evidence that ARV drugs affected the incidence of preterm delivery or increased low birth weight rates, Apgar scores, or fetal mortality. 18,19 In the present series, the resolution of pregnancy occurred after 38.5 weeks among the patients taking an ARV scheme containing a protease inhibitor, with no difference from the other groups, including the Control Group. These results are in accordance with those obtained in the PACTG 367, an observational study involving 1,472 HIV-1-infected pregnant women, 1,150 of them treated with a combined scheme, in which no association was observed between the use of these medications and preterm deliveries.…”

Determinants of Mother-to-Infant Human Immunodeficiency Virus 1 Transmission Before and After the Introduction of Zidovudine Prophylaxis

“…2,3 Guidelines for HIV-1-infected pregnant women recommend that zidovudine prophylaxis should be associated with combined ART 9 since, at present, only zidovudine and nevirapine therapies have been demonstrated to effectively prevent mother-toinfant transmission. 1,21 In our study, 95% of women receiving combined ART had zidovudine included in their regimen and/or as part of the other 2 parts of the PACTG 076 protocol. Whether perinatal HIV-1 transmission may be equally preventable by other combined antiretroviral regimens independent of whether zidovudine is included or not remains to be seen.…”

Impact of Maternal HIV Infection on Pregnancy and Labour Complication and Perinatal Health Outcomes: A South African Retrospective Study

“…Additionally, we demonstrate signi cantly shorter duration of active labour in women with HIV compared towomen without, both before and after the COVID-19 pandemic. Our ndings corroborate previous reports, which indicate that prolonged labour increases the risk of mother-to-child HIV transmission, HIV infected women typically have shorter active labour periods than uninfected women [40][41][42]. Current clinical management plans strive to reduce the duration of labour as a means to reduce foetal exposure to the virus through maternal blood and cervical secretions [40].…”

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

“…There was no evidence that ARV drugs affected the incidence of preterm delivery or increased low birth weight rates, Apgar scores, or fetal mortality. 18,19 In the present series, the resolution of pregnancy occurred after 38.5 weeks among the patients taking an ARV scheme containing a protease inhibitor, with no difference from the other groups, including the Control Group. These results are in accordance with those obtained in the PACTG 367, an observational study involving 1,472 HIV-1-infected pregnant women, 1,150 of them treated with a combined scheme, in which no association was observed between the use of these medications and preterm deliveries.…”

Determinants of Mother-to-Infant Human Immunodeficiency Virus 1 Transmission Before and After the Introduction of Zidovudine Prophylaxis

“…2,3 Guidelines for HIV-1-infected pregnant women recommend that zidovudine prophylaxis should be associated with combined ART 9 since, at present, only zidovudine and nevirapine therapies have been demonstrated to effectively prevent mother-toinfant transmission. 1,21 In our study, 95% of women receiving combined ART had zidovudine included in their regimen and/or as part of the other 2 parts of the PACTG 076 protocol. Whether perinatal HIV-1 transmission may be equally preventable by other combined antiretroviral regimens independent of whether zidovudine is included or not remains to be seen.…”