HIV-seropositive Pregnant Women Research Articles

Pregnancy-associated Plasma Protein-A, Progesterone, and Oestriol Levels and Some Birth Outcomes in HIV-seropositive Pregnant Women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Abstract Background: Pregnancy is associated with biochemical alterations and may be compounded by human immunodeficiency virus (HIV) infection potentially affecting pregnancy outcome such as birth weight, Apgar score, and foetal viability (stillbirth or intrauterine foetal death [IUFD]). Aims: This prospective case–control study evaluated some biochemical parameters and their possible effects on pregnancy outcome in HIV-seropositive subjects. Patients, Materials and Methods: The study involved 136 HIV seropositives on highly active antiretroviral therapy and 137 HIV-seronegative pregnant women, recruited from the Antenatal Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Pregnancy-associated plasma protein-A (PAPP-A), oestriol (E3), and progesterone were analysed using an enzyme-linked immunosorbent assay method, and the delivery outcomes were reported. Results: Progesterone was significantly higher (P = 0.002) in HIV-seropositive individuals (59.3 ± 17.84 ng/mL) compared to controls (54.89 ± 8.24 ng/mL). There were no significant differences in the levels of E3 and PAPP-A between the two groups. In HIV seronegatives, there were no significant changes in measured biochemical parameters between trimesters (P > 0.05). There were no significant differences in measured biochemical parameters between subjects with IUFD and subjects with live births (P > 0.05) for both the test and control groups. Subjects with significantly lower PAPP-A in HIV seropositives had babies with higher Apgar score. The incidence of IUFD was 7.31% among HIV seropositives and 7.47% among HIV seronegatives. Conclusion: HIV infection affects some biochemical indices such as progesterone and PAPP-A but does not adversely affect pregnancy outcomes in HIV seropositives under antiretroviral therapy.

Late antiretroviral refills and condomless sex in a cohort of HIV-seropositive pregnant and postpartum Kenyan women.

IntroductionThe postpartum period can be challenging for women living with HIV. Understanding how the postpartum period impacts ART adherence and condomless sex could inform the development of comprehensive sexual and reproductive health and HIV services tailored to the needs of women living with HIV during this critical interval.MethodsIn a longitudinal cohort study of HIV-seropositive Kenyan women, late ART refills and self-reported condomless sex were compared between the woman’s pregnancy and the postpartum period. Analyses were conducted using generalized estimating equations and adjusted for alcohol use, depressive symptoms, intimate partner violence (IPV), and having a recent regular partner. Effect modification was explored for selected variables.Results and discussion151 women contributed visits. Late ART refills occurred at 7% (32/439) of pregnancy visits compared to 18% (178/1016) during the postpartum period (adjusted relative risk [aRR] 2.44, 95% confidence interval [CI] 1.62–3.67). This association differed by women’s education level. Women with ≥8 years of education had late ART refills more during the postpartum period than pregnancy (aRR 3.00, 95%CI 1.95–4.62). In contrast, in women with <8 years of education, late ART refills occurred similarly during pregnancy and the postpartum period (aRR 0.88, 95%CI 0.18–4.35). Women reported condomless sex at 10% (60/600) of pregnancy visits compared to 7% (72/1081) of postpartum visits (aRR 0.76, 95%CI 0.45–1.27). This association differed by whether women had experienced recent IPV. Women without recent IPV had a significant decline in condomless sex from pregnancy to postpartum (aRR 0.53, 95%CI 0.30–0.95) while women with recent IPV had no significant change in condomless sex from pregnancy to postpartum (aRR 1.76, 95%CI 0.87–3.55).ConclusionImproved support for ART adherence during the postpartum period and addressing IPV to limit condomless sex could improve HIV treatment and prevention outcomes for HIV-seropositive women as well as their infants and sexual partners.

Uptake of PPTCT services among HIV sero-positive pregnant women in Mumbai, India - A descriptive study

BackgroundPrevention of parent to child transmission of HIV is a major programme to control the main cause of new HIV infections among children. The successful implementation of the programme requires timely linkages to testing, ART treatment, follow-up and care at various levels of the cascade. The study measures these key points in the Prevention of Parent to Child Transmission (PPTCT) programme which are crucial for achievement of elimination of neonatal HIV transmission. MethodsThe study is a retrospective observational cohort study based on records of services provided to HIV sero-positive pregnant women enrolled for antenatal care at the 36 PPTCT centres across Mumbai during the period April 2014 to March 2015 and their follow-up till pregnancy outcome till October 2015. ResultsIn the Antenatal clinics, 1,20,892 pregnant women were tested for HIV during the study period, of which 520 (0.43%; 95% CI: 0.39–0.47) women tested positive. The median time of ANC registration is 22 weeks of gestation, median time to ART linkage following testing is 5 days and median duration of ART received by the ANC mother is 17.4 weeks. Of the total pregnancies (523), 85.1% resulted in live births, 3.1% were induced abortions, 2.5% ended in spontaneous abortions and 2.7% in still births. ConclusionThe successful implementation of the PPTCT programme is mainly dependent on the important linkages and follow-up for eliminating the transmission of HIV to newborns and for providing reproductive rights to HIV sero-positive parents without fear of transmitting the infection to the child.

Variation of CD4 count in pregnant women living with HIV

The CD4+ T lymphocyte count gives crucial information on the status of a patient’s immune system and can be affected by several factors, including pregnancy. In HIV seropositive pregnant women, a steady decline of CD4 percentages has been observed during pregnancy and post-partum. Drastic variations in recommendations for CD4 monitoring among pregnant women living with HIV (WLWHIV) between countries create a necessity for further research on the matter.

Serological survey and risk factors associated with Toxoplasma gondii infection among HIV-infected pregnant women attending Abuja Tertiary Hospital, Nigeria.

Toxoplasmosis in pregnancy could induce miscarriage, congenital anomalies in foetuses and encephalitis in HIV-infected people. Hence, there is a need to determine the prevalence of toxoplasmosis in HIV-infected pregnant women to inform clinicians about the significance of maternal toxoplasmosis in antenatal care. This study aimed to determine the seroprevalence of Toxoplasma gondii infection, associated CD4+ T-cell profile and sociodemographic risk factors among pregnant women with or without HIV infection attending the University of Abuja Teaching Hospital, Abuja, Nigeria. This hospital-based cross-sectional study involved blood samples collected from 160 HIV-infected and 160 HIV-seronegative pregnant women. These samples were analysed for anti-T. gondii (IgG and IgM) and CD4+ T-cell count using ELISA and flow cytometry, respectively. Sociodemographic variables of participants were collected using structured questionnaires. The overall seroprevalence of anti-T. gondii IgG and IgM was 28.8% and 3.8%, respectively. The seroprevalence of anti-T. gondii IgG and IgM was 29.4% and 4.4%, respectively, among HIV-seropositive pregnant women and 28.1% and 3.1%, respectively, among HIV-seronegative women. There was no significant association between the seroprevalence of anti-T. gondii-IgG and anti-T. gondii-IgM with age, gestational age, education level, parity or place of residence of HIV-infected pregnant women (P > 0.05). However, there was significant association between the seroprevalence of anti-T. gondii-IgG (P = 0.03) and anti-T. gondii-IgM (P = 0.01) with education level. CD4+ T-cell count varied significantly between HIV-infected and HIV-uninfected pregnant women (P = 0.035). In this study, the seroprevalence of anti-T. gondii IgG and IgM did not differ in HIV-seropositive or HIV-seronegative pregnant women. However, women with primary T. gondii and HIV coinfection had lower CD4+ T-cell count than those with toxoplasmosis monoinfection.

Gelatin and Glycerine-Based Bioadhesive Vaginal Hydrogel.

The work's aim was the preparation and characterization of a hydrogel based on gelatin and glycerine, useful for site-specific release of benzydamine, an anti-inflammatory drug, able to attenuate the inflammatory process typical of the vaginal infection. The obtained hydrogel has been characterized by Electronic Scanning Microscopy (SEM) and Differential Scanning Calorimetry (DSC). In addition, due to the precursor properties, the hydrogel exhibits a relevant mucoadhesive activity. The swelling degree was evaluated at two different pHs and at defined time intervals. In particular, phosphate buffers were used at pH 6.6, in order to mimic the typical conditions of infectious diseases at the vaginal level, particularly for HIV-seropositive pregnant women, and pH 4.6, to simulate the physiological environment. The obtained results revealed that the hydrogel swells up well at both pHs. Release studies conducted at both pathological and physiological pHs have shown that benzydamine is released at the level of the vaginal mucosa in a slow and gradual manner. These data support the hypothesis of the hydrogel use for the site-specific release of benzydamine in the vaginal mucosa.

Possible Impact of Select Trace Mineral Deficiency in HIV Seropositive Pregnant Women with/without Malaria Co-infection in NAUTH, Nnewi, Nigeria

Aims: To evaluate the impact of HIV and malaria on serum Zinc (zn), Selenium (se) and Magnesium (mg) in HIV seropositive pregnant women in Nnewi, Nigeria.&#x0D; Study Design: This is a case-control study.&#x0D; Place and Duration of Study: Prevention of Mother to Child transmission (PMTCT) of HIV Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi, (NAUTH), Nigeria, between December, 2017 and April, 2018.&#x0D; Methodology: We included 122 consented female participants; 32 HIV seropositive pregnant women with malaria parasitaemia, 30 HIV seropositive pregnant women without malaria parasitaemia, 30 Malaria infected pregnant women, 30 pregnant women without HIV or malaria parasitaemia, aged between 18 and 42 years. Screening for HIV antibodies and malaria parasite was double screened using National algorithm, rapid detection technique (RDT) and Giemsa staining microscopy technique respectively. Micronutrient levels were determined using atomic absorption spectrophotometry (AAS).&#x0D; Results: When the mean zn, sel and mg levels were compared between the test and control groups, significant decreases in serum zn (37.34 ± 6.7, 36.70 ± 4.39), sel (29.93 ± 6.02, 28.00 ± 5.04) and mg (2.41 ± 0.46, 2.33 ± 0.14) were observed in HIV seropositive pregnant participants with/without malaria co-infection when compared with their corresponding controls Zn (45.1 ± 7.83, 50.36 ± 8.73); Sel (31.46 ± 6.19, 31.96 ± 6.81); Mg (2.62 ± 0.30) and (P &lt; .05 respectively). Body mass index (BMI) was significantly decreased while diastolic blood pressure (DBP) and systolic blood pressure (SBP) were significantly increased in HIV seropositive pregnant women with malaria compared with their seronegative counterparts (P &lt; .05 respectively).&#x0D; Conclusion: The significant loss in BMI with derangement in serum zn, sel and mg levels in HIV seropositive pregnant women with/without malaria co-infection indicates high degree of malnutrition while the increased blood pressure suggests high blood pressure which might predispose the pregnant mothers to pre-eclampsia if not properly managed. Adequate micronutrient supplementation and effective anti malaria agent is strictly advocated in the routine management of HIV infected mothers during pregnancy to reduce the severity of the co-infection and adverse pregnancy complications especially in areas of malaria endemic transmissions.

Práticas de gestantes soropositivas para HIV sobre o autocuidado: Construção de Tecnologia Educacional em Saúde

Objetivo: Construir uma tecnologia educacional em saúde para gestantes soropositivas para HIV. Métodos: Estudo descritivo, de natureza qualitativa, do tipo pesquisa participante. Participaram do grupo focal 10 gestantes com HIV. Após a dinâmica do grupo focal, foram analisados os depoimentos das mesmas e construído uma tecnologia educacional contendo os principais questionamentos das participantes e respostas com referencias de estudos realizados pelo Ministério da Saúde. Resultados: Com a metodologia realizada, foi possível construir como produto um vídeo educativo denominado “A gravidez em mulheres com HIV: vamos falar sobre?”. Sobre os questionamentos delas, foi possível destacar que elas não sabiam como realizar o autocuidado de forma correta e que apresentam medo perante o estigma contido na doença. Conclusão: A elaboração de ferramentas educacionais se apresenta como forma de sanear dúvidas e apresenta-se como forma de aumento de vínculo entre o profissional e a usuária.

Antibiotic Drug Resistance in HIV Seropositive Pregnant Women

Background: Vaginal infections are often associated with a significant risk of morbidity especially in pregnant women. These infections if left untreated often result in a long-term sequelae and poses a higher adverse pregnancy outcome especially in immunocompromised women. While HIV infection has been reported to be a high risk of pathogenic bacterial colonization, the misuse of antibiotics is high among women in developing countries. Methodology and results: A high vaginal swab was collected from the posterior fornix from each pregnant women by the attending physician using sterile bivalve speculum and a cotton- tipped applicator. Each sample was cultured and identified using standard bacterlogical methods. Selected pathogens were thereafter tested for their sensitivity to 23 commonly prescribed antibiotics using the Kirby-Bauer method. Altogether, 1,156 bacterial isolates were cultured from high vaginal swabs of both 114 HIV seropositive and 126 HIV seronegative pregnant women, averaging 4.81 bacterial per subject each for both cohorts. S. aureus was seen as the single predominant isolate recovered from both groups. In addition, of the 22 S. aureus recovered from HIV infected women, 10 isolates were Methicillin resistant S. aureus (MRSA) and 12 Methicillin sensitive S aureus (MSSA), while, of the 25 S. aureus recovered from HIV seronegative women, 13 isolates were Methicillin resistant S. aureus (MRSA) and 12 Methicillin sensitive S aureus (MSSA). Other gram negative pathogens associated with lower genital infections were also studied. Conclusion: The incidence of multiple antibiotic resistance was high among isolates recovered from both cohorts, which is probably due to uncontrollable ease of access to these antibiotics in the environment where antibiotics restriction/policy is lacking. There is an urgent need for continuous monitoring, health education, drug abuse awareness and implementation of interventions to restrict antibiotic abuse especially among immunocompromised individuals in the study environment.

Bacterial colonization of the vagina, oropharynx, breast milk and anterior nares of neonates among HIV seropositive pregnant women and seronegative pregnant counterparts

Introduction The human Immunodefiency virus acquired immune deficiency syndrome HIV AIDS is a scourge to mankind because the disease has devastated and decimated communities worldwide in the last two or more decades yet there is no cure Incidence of HIV AIDS in Nigeria is high where of the global incidence occurs The study determined the colonization of the vagina oropharynx breast milk and nares of neonates in clinics at Akure South and Ifedore Local Government Area LGA in Ondo State Nigeria from November to December Methodology Two hundred and forty pregnant women aged years were involved in the study HIV seropositive subjects mean age years and HIV seronegative subjects mean age years as controls HIV serostatus of each participant was determined by HIV strip and confirmed by the Abbott enzyme linked immunosorbent assay procedure High vaginal sawbs breast milk samples oropharynx swabs and nares of each neonate were collected using sterile cotton tipped applicator and introducing each into freshly prepared thioglycollate fluid medium for growth Bacterial isolates were charcterised by standard microbiological methods and API kits Results bacterial isolates were recovered from the four study sites HVS oropharynx breast milk samples and anterior nares of neonates Our study showed against compared to and against of the predominant pathogens encountered among HIV seropositive and seroneagtive subjects respectively Conclusion HVS constituted the major isolates oropharynx breast milk and nares of neonates

Periodontal health status among HIV-seropositive pregnant women.

Routine oral health care is essential for those living with HIV (human immunodeficiency virus) infection, especially in pregnant women. Hormonal changes during pregnancy, immunosupression in HIV along with bacterial load in periodontal infections strongly influence the pregnancy outcomes. The aim of this study was to evaluate the periodontal health status in HIV seropositive pregnant women in Andhra Pradesh, India. This study includes a sample of 90 divided into three groups; HIV seropositive pregnant women (group PH; n = 30), HIV seropositive nonpregnant women (group H; n = 30), and healthy pregnant women without HIV infection (group P; n = 30). Clinical examination includes the recording of probing depths (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and periodontal screening and recording index (PSR) were assessed in three groups. Statistical analysis was done by Mann-Whitney U-test and Wilcoxon paired test using the software SPSS version 17. Clinical parameters do not show any significant variation between the three groups. But slightly higher mean PD and CAL levels was observed in HIV seropositive pregnant and nonpregnant women compared with healthy pregnant women without HIV infection. About 13% of severe gingivitis cases were observed in HIV seropositive pregnant group compared with 6% in HIV seropositive and 3% in healthy pregnant group. Presence of slightly higher percentage of severe gingivitis in HIV seropositive pregnant women strengthens the fact of extra need for preventive oral health services during the prenatal period and provides recommendations for promoting maternal oral health in regional antiretroviral therapy centers in India.

Effect of depressive symptoms and HIV exposure on the quality of life of HIV-seropositive and seronegative pregnant women

Introduction: Depression among human immunodeficiency virus (HIV)-seropositive individuals has been associated with reduced quality of life. Objective: To evaluate the effect of depressive symptoms and HIV exposure on mean quality of life scores in HIV-seropositive and HIV-seronegative postpartum women. Methods: A cross-sectional study was conducted with two groups: 80 HIV-seropositive and 80 HIV-seronegative postpartum women. The Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life short-version scale were used to assess presence of depressive symptoms and quality of life scores. Two-way analysis of variance was used to compare the effects of depressive symptoms, HIV exposure and interaction between depressive symptoms and HIV exposure on mean quality of life scores, with p &lt; 0.05 considered statistically significant. Results: Depressive symptoms were present in 35% (28) of HIV-seropositive and 17.5% (14) of HIV-seronegative participants (p = 0.02). The interaction between depressive symptoms and HIV exposure was not significant for any quality of life domain. The main effect of HIV exposure was also not significant. Depressive symptoms had a negative influence on quality of life scores in all domains (physical health, psychological health, social relationships and environment) (p &lt; 0.001). Conclusion: The quality of life of pregnant women is negatively influenced by the presence of depressive symptoms. Keywords: Pregnancy; quality of life; depression and HIV

Effect of fish oil omega-3 fatty acids on reduction of depressive symptoms among HIV-seropositive pregnant women: a randomized, double-blind controlled trial

BackgroundGlobally, it is known that HIV-infected pregnant women are prone to depressive symptoms. Research evidences also suggest that nutrient deficiencies may enhance the depressive illness, and that fish oil omega-3 fatty acids may alleviate the depressive symptoms. The aim of this study was to assess the effect of fish oil omega-3 eicosapentaenoic acid-rich supplements on depressive symptoms among HIV-seropositive pregnant women.Trial designA randomized double-blinded controlled trial with two parallel groups was conducted. The intervention group received fish oil omega-3 of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) per day for 8 weeks, while the control group received soybean oil for a similar period.MethodParticipants were HIV-seropositive pregnant women who were enrolled in prevention of mother-to-child transmission programs and attending antenatal clinics at selected Nairobi city county’s health facilities. Recruitment was done from health records of HIV-infected pregnant women. Data analysis followed per-protocol analysis. Participants who completed the 8-week trial were included in the analysis of covariance statistical model with omega-3 as main effect. The covariates in the change in BDI-II depressive symptom score outcome were baseline characteristics and nutrient adequacy.Results282 participants were recruited 109 randomized to fish oil, and 107 to soybean oil. Completion rate was 86/109 (78.9%) and 96/107 (89.7%) respectively. At the end of week-8 of follow up most participants in both arms had mild depressive symptoms 82/86 (95.3%) in the Fish oil group and 94/96 (97.9%) in the Soybean oil group. The difference in effect between the intervention and control group was not statistically significant (1.01 (95% CI − 0.58 to 2.60), p = 0.21).ConclusionFish oil omega-3 with a daily dosage of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) appears to provide no added benefit in reduction of the symptoms of depression in HIV-infected pregnant women.Trial Registration Clinical Trial Registry: NCT01614249. Registered on June 5, 2012. https://clinicaltrials.gov/ct2/show/NCT01614249

Extracellular enzymes and βeta-lactamase screening of bacterial isolates cultured from urine samples of immunocompromised women

Enzymes intricate by organisms are used to inactivate and destroy antibiotics. This study determined some virulence factors elaborated by the bacterial isolates cultured from urine samples of HIV seropositive pregnant women that attended antenatal clinic of the Ondo State Specialist Hospital, Akure. Screening for extracellular enzymes and extended spectrum beta lactamase (ESBL) of the isolate was carried out using standard method and disk approximation method respectively. The extracellular enzymes such as lipase, protease and DNase were detected in the three bacterial genera used. ESBL was found in S. aureus and E. coli. The study concluded that most of the bacterial isolates cultured from urine samples of HIV seropositive pregnant women in the study area were found to have these virulence factors.

Determinants of disclosure and non-disclosure of HIV-positive status, by pregnant women in rural South Africa

ABSTRACTDisclosure of HIV status remains one of the major challenges to the effectiveness of the prevention of mother to child transmission of HIV in rural areas in South Africa. This study aimed at assessing the determinants of HIV status disclosure among HIV infected pregnant women who have disclosed their HIV status to someone, as well as among those who have disclosed to their partners. Cross-sectional data was collected from 673 HIV sero-positive pregnant women receiving antenatal care services at 12 Community Health Centers in Mpumalanga province. Results indicated that over two-thirds (72.1%) disclosed their status to someone, while just over half (58.4%) disclosed to their partners. Multivariate analysis showed that both disclosure of ones HIV status to someone and to their male partners was significantly associated with increase in antiretroviral therapy (ART) adherence, the known HIV positive status of their partner, and male involvement during pregnancy. Participants who were diagnosed HIV positive during this current pregnancy were less likely to disclose their HIV status to someone. Non-disclosure during current pregnancy highlights a need for interventions that will encourage disclosure among HIV positive women, with a particular focus on those who are newly diagnosed. The findings also need to integrate male partner involvement and partner disclosure during pregnancy.

The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of maternal antiretroviral therapy among HIV-seropositive pregnant women in sub-Saharan Africa: a systematic review and meta-analysis

ObjectivesTo identify the approaches that are used in improving on male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV and their impact on the uptake maternal antiretroviral...

Occurrence of transmitted HIV-1 drug resistance among Drug-naïve pregnant women in selected HIV-care centres in Ghana.

Access to antiretroviral therapy in Ghana has been scaled up across the country over the last decade. This study sought to determine the occurrence of transmitted HIV-1 drug resistance in pregnant HIV-1 positive women yet to initiate antiretroviral therapy at selected HIV Care Centres in Ghana. Plasma specimens from twenty-six (26) HIV seropositive pregnant women who were less than 28weeks pregnant with their first pregnancy and ART naïve were collected from selected HIV care centres in three (3) regions in Ghana. Genotypic testing was done for the reverse transcriptase gene and the sequences generated were analyzed for HIV-1 drug resistance mutations using the Stanford University HIV Drug Resistance Database. Resistance mutations associated with the reverse transcriptase gene were detected in 4 (15.4%) of the participants. At least one major drug resistance mutation in the reverse transcriptase gene was found in 3 (11.5%) of the women. The detection of transmitted HIV-1 drug resistance in this drug-naïve group in two regional HIV care sites is an indication of the need for renewed action in monitoring the emergence of transmitted HIV-1 drug resistance in Ghana. None declared.

Evaluation of risk factors in MTCT among HIV-seropositive pregnant women in selected centers in Akure, South Western Nigeria

Background: The burden of mother-to-child transmission (MTCT) of HIV remains a major challenge in Nigeria, the country ranks highest globally. About 10% of global HIV-infected individuals live in Nigeria, of which 58% are women. The study analyzed risk and cofactors of MTCT in healthcare centers of Akure, Ondo State, Nigeria, between November 2014 and April 2016. Methods: A total of 240 pregnant women aged 19–43 years were recruited for the study, 114 HIV-seropositive mean age 31.81 years and 126 HIV-seronegative mean age 29.05 years as controls. High vaginal sawbs, breast milk, oropharynx, and neonates' nares were collected using sterile cotton-tipped applicator and introducing each into thioglycollate fluid medium for growth. Bacterial isolates were characterized by the standard microbiological methods and API kits. HIV serostatus of each participant was determined by HIV-1/2 strip and confirmed by Abbott enzyme-linked immunosorbent assay procedure. Sexually transmitted infections were detected by the enzyme immunoassays using commercial kits. Results: A total of 2,148 bacterial isolates were recovered from both cohorts (911 from HIV-seropositive, 864 HIV-seronegative, and 373 from neonates' nares). Predominant pathogens recovered were Staphylococcus aureus, Pseudomonas aeruginosa, and diverse corynebacteria as commensals. Coinfection of HIV with other sexually transmitted diseases (STDs) was prominent. About 92.1% of patients received combination ART. Neonates mortality rate was 10.5 and 7.8% mothers were potential transmitters. Spontaneous vaginal delivery accounted 91.7% deliveries. Conclusion: Incidence of STDs among HIV-seropositive was 77.5 and 22.5% for HIV-seronegative. Incidence of spontaneous vaginal delivery was 91.7% in HIV-seropositive women and 10.5% mortality rate recorded for neonates and 7.8% transmission for mothers posed high risk of MTCT, which is epidemiological significant.

Depressive Symptomatology, TNF-α, and Perinatal Outcomes among HIV-Seropositive Pregnant Women

Many factors may be associated with depressive symptomatology among HIV seropositive pregnant women, in whom the prevalence of depression is relevant. Several studies have suggested that depression is an inflammatory condition, in terms of cytokine production. Moreover, pregnant women infected with HIV may have altered cytokine levels due to their infectious condition and pregnancy-related immunomodulation. Thus, we propose that depressive symptomatology during pregnancy could affect not only cytokine production but gestational outcomes as well. The aim of this observational, prospective, cross-sectional and non-random sampled study was to evaluate the prevalence of depressive symptomatology and its relationship to perinatal outcomes and levels of pro-inflammatory cytokines among HIV-infected pregnant women. Depressive symptomatology was related to lower newborn weight, and gestational age at delivery among HIV-infected pregnant women with CD4+ lymphocytes below 350 cells/mm3. Participants who obtained higher scores in the Zung Self-rated Depression Scale had lower levels of Tumor Necrosis Factor alpha (TNF-α,) whereas Interferon-gamma (IFN-γ) levels were similar in participants with low and high depressive symptomatology. In this study, it was found that increased maternal depressive symptomatology, combined with CD4+ lymphocytes below 350 cells/mm3, was related not only to lower newborn weight and height, but to lower gestational age at delivery as well.

Coinfections of Human Immunodeficiency Virus and Sexually Transmitted Infections among HIV Seropositive Pregnant Women at Healthcare Centres in Akure, Southwestern Nigeria

Background: Sexually transmitted infections (STIs) represent significant risk factors for HIV transmission and adverse fetal complications in pregnancy. We tested 240 pregnant women for their HIV serostatus and for the effects of HIV-STI coinfections on CD4+ cell counts and on HIV plasma viral load. The study was conducted at four antenatal clinics in Akure, Ondo State of Nigeria between November 2014 and December 2015. Methods: The HIV-1/2 strip was used for preliminary determination of HIV serostatus and this was followed by a confirmatory Abbott enzyme-linked immunosorbent assay (ELISA) procedure. CD4+ T-cell counts were done by cytometric analysis while viral load was determined by COBAS® AmpliPrep TaqMan HIV-1 procedure. Liver enzymes were determined by an automated chemistry analyzer. Detection of hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus-6 (HPV-6) and herpes simplex virus type-2 (HSV-2) were determined by ELISA. The syphilis VDRL test was done by the rapid plasma reagin procedure, while Trichomonas vaginalis infection was demonstrated by the wet mount procedure. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae were determined respectively by ELISA and by culture on proteose peptone agar supplemented with 5% serum. Results: The results show prevalence of STIs in 33.3% of the 240 study participants; 77.5% for HIV seropositive and 22.5% for seronegative subjects. Trichomonas vaginalis constituted the highest isolate Coinfections in 50% of HIV seropositive subjects and 22.2% for seronegative controls. HIV-HBV coinfection occurred among 7 individuals while HIVHBV-TV coinfection occurred in 4 individuals. The results also showed elevated titers of alanine aminotransferase (ALT), creatinine and total bilirubin liver enzymes in both HIV-HBV coinfection and HBV monoinfection. HIV viral loads were twice as high in HIV-HBV coinfection relative to HBV mono- infection. Conclusion: The prevalence of STIs was significantly high at 54.4% among HIV seropositive pregnant women as compared to 14.3% for HIV seronegative pregnant women. T. vaginalis was the highest isolate at 50% in HIV seropositive subjects and may therefore be a driving factor for HIV transmission and susceptibility as very few T. vaginalis infections were recorded in control subjects.