Patterns of pregnancy loss among women living with and without HIV in Brazil, 2008–2018

Yang, Lanbo; Cambou, Mary Catherine; Segura, Eddy R.; Melo, Marineide; Varella, Ivana Rosângela dos Santos; Nielsen‐Saines, Karin

doi:10.1016/j.xagr.2022.100121

Cited by 3 publications

(3 citation statements)

References 55 publications

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“…However, determining the etiology of pregnancy loss in the case of HIV infection is difficult due to the possibility of the coexistence of genetic abnormalities and coexisting systemic diseases, such as endocrine, infectious, autoimmune and hematological factors. In HIVinfected women, pregnancy loss is a known adverse effect associated with an unsuppressed viral load; the viral load may be a significant determinant of this risk in a dose-dependent manner [61]. Research conducted in 2015 in the USA showed that a pregnant woman's viral load, as measured by plasma HIV RNA, predicted pregnancy loss significantly better than a lifetime cumulative viral load [62].…”

Section: Hivmentioning

confidence: 99%

“…Research conducted in 2015 in the USA showed that a pregnant woman's viral load, as measured by plasma HIV RNA, predicted pregnancy loss significantly better than a lifetime cumulative viral load [62]. Although the etiology of pregnancy loss has many factors, altered immune activation and prolonged inflammation, which are induced by HIV infection, are significant by interfering with decidual maintenance and contributing to placental dysfunction [61].…”

Section: Hivmentioning

confidence: 99%

“…Diagnostics of HIV infection, which is one of the factors of miscarriage, include rapid HIV tests implemented in many institutions [61]. Pregnant patients need to be screened early in pregnancy.…”

Section: Diagnosticsmentioning

confidence: 99%

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The Diagnostics and Treatment of Recurrent Pregnancy Loss

Tomkiewicz

Darmochwał-Kolarz

2023

JCM

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Recurrent pregnancy loss is a common problem in the reproductive age population of women. It can be caused by many different conditions. This problem is addressed in international guidelines that take a slightly different approach to its diagnosis and treatment. The guidelines used in this review mainly use the guidelines of the Royal College of Obstetricians and Gynaecologists (RCOG), American Society of Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology (ESHRE). This review shows how much the approach to miscarriages has changed and how much more needs to be explored and refined. The review also addresses the topic of unexplained pregnancy loss, which continues to be a challenge for clinicians.

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Section: Hivmentioning

confidence: 99%

Section: Hivmentioning

confidence: 99%

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The Diagnostics and Treatment of Recurrent Pregnancy Loss

Tomkiewicz

Darmochwał-Kolarz

2023

JCM

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The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission

2023

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Contribution of Syphilis to Adverse Pregnancy Outcomes in People Living With and Without HIV in South Brazil: 2008 to 2018

Yang,

Sundar,

Cambou

et al. 2024

Sexual Trans Dis

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Background Syphilis co-infection among pregnant people living with HIV (PLH) may worsen pregnancy outcomes. We evaluated the impact of syphilis co-infection on pregnancies in south Brazil. Methods Data was extracted from hospital records between 1/1/2008 -12/31/2018. Preterm birth (PTB), low birth weight (LBW < 2500 g), and a composite adverse infant outcome [AIO: HIV vertical transmission, loss to follow-up before HIV diagnosis (LTFU), stillbirth, congenital syphilis] were evaluated among pregnancies without HIV and syphilis (PWOH+S), PLH mono-infection, syphilis mono-infection (PLS), and PLH with syphilis (PLH + S). Results Among 48,685 deliveries where patients were tested for HIV and syphilis, 1,353 (2.8%) occurred in PLH; of these, 181 (13.4%) were HIV/syphilis co-infected (PLH + S). Among PLH, 2.4% of infants acquired HIV and 13.1% were LTFU. Among all PLS, 70.5% of infants acquired congenital syphilis. Across the cohort, 1.2% stillbirths/neonatal deaths occurred. 37.0% of PLH + S did not initiate ART versus 15.4% of PLH mono-infection (p < 0.001). 37.6% of PLH + S had VDRL titers >1:16 compared to 21.7% of PLS only (p < 0.001). Among PLH, syphilis co-infection and unknown/high VDRL titers (>1:16) increased AIO risk more (aRR:3.96, 95%CI:3.33-4.70) compared to low VDRL titers (<1:8) (aRR:3.51, 95%CI:2.90-4.25). Unsuppressed viremia (>50 copies/mL) was associated with risk of PTB (aRR:1.43, 95%CI:1.07-1.92) and AIO (aRR:1.38, 95%CI:1.11-1.70) but not LBW. Lack of prenatal care was significant in predicting PTB and LBW in all PLH and PLS mono-infection. Conclusion Syphilis co-infection worsens adverse infant outcomes in all women and compounds negative effects of HIV infection during pregnancy. Effective syphilis treatment and HIV VL suppression are paramount for optimal obstetric care.

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Patterns of pregnancy loss among women living with and without HIV in Brazil, 2008–2018

Cited by 3 publications

References 55 publications

The Diagnostics and Treatment of Recurrent Pregnancy Loss

The Diagnostics and Treatment of Recurrent Pregnancy Loss

The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission

Contribution of Syphilis to Adverse Pregnancy Outcomes in People Living With and Without HIV in South Brazil: 2008 to 2018

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