HIV-seropositive Women Research Articles

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.
 Study Design: This is a case-control study.
 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.
 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).
 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 < .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 < .05 respectively).
 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.

Impact of Biological Sex on Immune Activation and Frequency of the Latent HIV Reservoir During Suppressive Antiretroviral Therapy.

Persistent HIV infection of long-lived resting CD4 T cells, despite antiretroviral therapy (ART), remains a barrier to HIV cure. Women have a more robust type 1 interferon response during HIV infection relative to men, contributing to lower initial plasma viremia. As lower viremia during acute infection is associated with reduced frequency of latent HIV infection, we hypothesized that women on ART would have a lower frequency of latent HIV compared to men. ART-suppressed, HIV seropositive women (n = 22) were matched 1:1 to 22 of 39 ART-suppressed men. We also compared the 22 women to all 39 men, adjusting for age and race as covariates. We measured the frequency of latent HIV using the quantitative viral outgrowth assay, the intact proviral DNA assay, and total HIV gag DNA. We also performed activation/exhaustion immunophenotyping on peripheral blood mononuclear cells and quantified interferon-stimulated gene (ISG) expression in CD4 T cells. We did not observe evident sex differences in the frequency of persistent HIV in resting CD4 T cells. Immunophenotyping and CD4 T-cell ISG expression analysis revealed marginal differences across the sexes. Differences in HIV reservoir frequency and immune activation appear to be small across sexes during long-term suppressive therapy.

Circulating sclerostin is associated with bone mineral density independent of HIV-serostatus

BackgroundLow bone mineral density (BMD) is commonly observed in people living with HIV (PLWH), however the cause for this BMD loss remains unclear. Sclerostin, a bone-derived antagonist to the Wnt/β-catenin-pathway, suppresses bone remodeling and is positively associated with BMD. The goal of the current study was to investigate associations between sclerostin and BMD in a cohort of HIV-seropositive and demographically-matched seronegative women. MethodsThis cross-sectional analysis used a subset of early postmenopausal women enrolled in the Women's Interagency HIV Study (WIHS). BMD was assessed at the lumbar spine, total hip, femoral neck, and distal and ultradistal radius via dual energy x-ray absorptiometry (DXA). Circulating sclerostin was assessed via commercial ELISAs. Univariate and multivariate linear regression modeling tested associations between sclerostin and BMD after adjusting for a variety of BMD-modifying variables. ResultsHIV-seropositive women had significantly reduced BMD at all skeletal sites compared to HIV-seronegative women. There was no difference in sclerostin levels according to HIV-serostatus (0.25 vs 0.27 ng/mL in HIV-seronegative and HIV-seropositive, respectively, p = 0.71). Circulating sclerostin was positively associated with BMD at all sites in both univariate and multivariate models adjusting for HIV status, age, BMI, and race, although the coefficients of association were attenuated in HIV-seropositive women. The positive association between sclerostin and BMD among seropositive women remained statistically significant after adjusting for ART or tenofovir disoproxil fumarate (TDF) use. ConclusionsThe current study suggests that circulating sclerostin is a biomarker for bone mass for both HIV seronegative and seropositive women using and not using ART. The lower coefficients of association between sclerostin and BMD by HIV status may suggest HIV-induced alternation in osteocyte function.

The occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV seropositive women in Ahvaz, Southwest Iran

BackgroundVulvovaginal candidiasis (VVC) is a prevalent infection among HIV-seropositive women that still needs to be subjected to more researches. This study is aimed at determining the occurrence of vulvovaginal Candida species and their antifungal susceptibility pattern in HIV-seropositive women from the Behavioral Disease Counseling Center in Ahvaz, Iran. MethodIn this analytical cross-sectional study, 85 HIV-seropositive women with the mean age of 26.15 years (SD. 9.60) were evaluated. Vaginal swabs were collected from women to identify various Candida species through conventional methods and API 20 C AUX system. Antifungal susceptibility testing was done on specimens against Amphotericin B and Azole antifungals. Eventually, all data were analyzed by SPSS. ResultsThe occurrence of vulvovaginal Candida species was 34.11% (29) among 85 HIV-seropositive women. Out of 29 Candida spp., 18 (62.06%) C. albicans, 6 (20.68%) C. glabrata, 4 (13.79%) C. dubliniensis, and 1 (3.44%) C. krusei were identified. There was no significant association between VVC and some medical variables such as antiretroviral therapy, birth control methods, underlying diseases, and CD4 count (PV > 0.05). However, there was a significant association between VVC and age and pregnancy (PV < 0.05). The most Candida spp. showed considerably resistant to Amphotericin B and Itraconazole while all species were susceptible to Caspofungin. ConclusionThe high occurrence of Candida spp. (34.11%) among HIV-seropositive women is notable, with the highest frequency of C. albicans, C. glabrata and C. dubliniensis, respectively. Also, their notable resistance to Amphotericin B and Azole antifungals necessitates more effective treatments for VVC, particularly in pregnant women.

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.

Neighborhood Poverty and Control of HIV, Hypertension, and Diabetes in the Women's Interagency HIV Study.

Neighborhoods with high poverty rates have limited resources to support residents' health. Using census data, we calculated the proportion of each Women's Interagency HIV Study participant's census tract (neighborhood) living below the poverty line. We assessed associations between neighborhood poverty and (1) unsuppressed viral load [VL] in HIV-seropositive women, (2) uncontrolled blood pressure among HIV-seropositive and HIV-seronegative hypertensive women, and (3) uncontrolled diabetes among HIV-seropositive and HIV-seronegative diabetic women using modified Poisson regression models. Neighborhood poverty was associated with unsuppressed VL in HIV-seropositive women (> 40% versus ≤ 20% poverty adjusted prevalence ratio (PR), 1.42; 95% confidence interval (CI) 1.04-1.92). In HIV-seronegative diabetic women, moderate neighborhood poverty was associated with uncontrolled diabetes (20-40% versus ≤ 20% poverty adjusted PR, 1.75; 95% CI 1.02-2.98). Neighborhood poverty was associated with neither uncontrolled diabetes among HIV-seropositive diabetic women, nor uncontrolled hypertension in hypertensive women, regardless of HIV status. Women living in areas with concentrated poverty may need additional resources to control health conditions effectively.

Female genital tract shedding of HIV-1 is rare in women with suppressed HIV-1 in plasma.

Determine the frequency of genital HIV-1 shedding in a large cohort of women on long-term suppressive antiretroviral therapy (ART) and its association with mucosal inflammation. We measured levels of HIV-1 RNA and inflammation biomarkers in cervicovaginal lavage (CVL) from HIV-seropositive women enrolled in the Women's Interagency HIV Study (WIHS). HIV-1 was quantified (Abbott RealTime HIV-1 assay) from CVL samples of 332 WIHS participants with and without clinical evidence of genital inflammation at the time of CVL collection; participants had suppressed plasma viral load (PVL; limit of quantitation less than 20-4000 copies/ml depending on year of collection) for a median of 7.1 years [interquartile range (IQR) 3.4-9.8, Group 1] or for a median of 1.0 years (IQR = 0.5-1.0, Group 2). Twenty-two biomarkers of inflammation were measured in CVL to compare with clinical markers. HIV-1 was detected in 47% of 38 pre-ART CVL samples (median 668 copies/ml) and detection in CVL was associated with higher pre-ART PVL. HIV-1 was detected in only 1 of 38 CVL samples from these women on suppressive antiretroviral therapy for 1 year. No HIV-1 RNA was detected in 294 CVL samples from a cross-sectional set of women with suppressed PVL for a median of 7 years. Clinical inflammation markers were correlated with inflammatory biomarkers in CVL specimens, although genital inflammation was not associated with measurable genital HIV-1 shedding in these WIHS participants on ART. ART that suppresses HIV-1 in the plasma of women also prevents genital tract HIV-1 shedding, even in the presence of genital tract inflammation.

Determination of antibodies to human immunodeficiency virus type 1&2&O and P24 – antigen in pregnant women in port harcourt Nigeria

ABSTRACTThe need for a cure against HIV infection and a need to improve HIV screening amongst low risk population such as pregnant women have been an issue since the emergence of HIV. Therefore, a hospital-based cross-sectional study was adopted to determine the prevalence of antibodies to HIV-1/2/O and P24 antigen among pregnant women in Port Harcourt, Nigeria. Estimating the HIV seropositivity in pregnant women will offer vital information for monitoring the trend of HIV infection in the general population and assist in prevention from mother-to-child transmission. The occurrence of antibodies to HIV type 1/2/O and P24 antigen among the pregnant women was investigated using fourth-generation ELISA. The influence of the women’s age, marital status, occupation, educational status and gestation period on the prevalence of these antibodies against HIV type 1/2/O and P24 antigen was also considered. Of the 86 pregnant women, 14 were found to be HIV-positive with seropositivity rate of 32.6%. Majority of HIV seropositive women (41.2%) were in the age group of 31–42 years. Higher seropositivity was observed among singles (50.0%), those with secondary education (44.7%), unemployed (47.8%) and in those in their third trimester (40.0%). Additionally, this study observed high seropositivity of antibodies to HIV type 1, 2, O and P24 antigen among pregnant women in Port Harcourt, Nigeria and calls for urgent and concerted efforts aimed at promoting behavioral and socio-cultural practices that could change the current high rate of HIV seropositivity amongst pregnant women in Nigeria. A combination of preventive strategies such as the use of condoms, breaking the chain of transmission within sexual networks by prompt treatment and reducing the amount of unsafe sexual behavior, promoting sexual abstinence and behavioral change from high-risk behavior are advocated.

2548. Provider Adherence to Cervical Cancer Screening in HIV Patient Populations

BackgroundAntiretroviral therapy has nearly normalized the life expectancy of people living with HIV (PLWH). However, malignancies still remain a major cause of morbidity and mortality in PLWH, and thus an important part of the clinical visit is age appropriate screening and referral to care, from Lancet 2019 for the poster. Most cases of cervical cancer occur in women who were either never screened or were screened inadequately. Over-screening for cervical cancer, on the other hand, leads to unnecessary stress and procedures, adding increased costs to the patient and to the healthcare system. The central aim of this project is to evaluate provider adherence at the Immunology Center (IC) to cervical cancer screening guidelines and to identify factors associated with over and underscreening.MethodsA retrospective chart review from January 1, 2015, to December 31, 2017 was performed. Study included HIV-seropositive women seen at the IC between April 2014 and June 2018. Exclusion criteria includes prior hysterectomy, abnormal cytology, cervical excision procedures, or other causes of immunosuppression.ResultsOf the 803 HIV-positive women identified, n = 262 met criteria for inclusion in the study. Overall adherence was 48%, with statistical significance found in cervical cancer screening between MDs and NPs, with an OR = 2.51 (P < 0.01). In regard to gender of provider, statistical significance in over screening was found between male and female providers, with an OR = 4.3 (P < 0.01), and in under screening between male and female providers, with an OR = 0.43 (P < 0.05). Over screening led to 44 excess pap smears over a 2-year period, yielding an excess cost of $6461. HPV co-testing was underutilized, with only one-third of encounters having HPV testing performed.ConclusionThis project gives us the opportunity to reeducate and retrain the clinical staff and practitioners providing cervical cancer screening at the Immunology Center. This is an ongoing quality improvement project, where adherence will be reassessed on a continuous basis at one-year intervals to ensure compliance with guidelines-based cervical cancer screening among female HIV seropositive patients at the Immunology Center. Disclosures All authors: No reported disclosures.

"Demand what you prefer": the role of sexual assertiveness among HIV-infected women

Aim: This study was conducted to evaluate sexual assertiveness among HIV-infected women, and to address the relationship between sexual assertiveness, sociodemographic characteristics, sexual and fertility profile, and HIV-related variables in this population. Design: A cross sectional study. Methods: The research was conducted with a sample of 93 eligible HIV-infected women referred to Imam Khomeini hospital between September 2016 and January 2018. The Hurlbert Index of Sexual Assertiveness was used to assess sexual assertiveness. Results: Mean and standard deviation of sexual assertiveness was 51.33 (20.16). We found a significant relationship between age (p = 0.04), education (p = 0.03), pregnancy experience (p = 0.003), age at the time of first sexual contact (p = 0.005), and disclosure of HIV sero-status to sexual partners (p = 0.05) and sexual assertiveness. Binary logistic regression results showed that age (p = 0.04), having live children (p = 0.003), and disclosure of HIV sero-status to sexual partners (p = 0.04) could significantly predict sexual assertiveness score. Conclusion: Our findings showed that level of sexual assertiveness in HIV sero-positive women deserves more attention. In addition, consideration should be given to sexual health related issues and sexual assertiveness skills during routine HIV care appointments.

Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study

ObjectivesWe assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART) in Kampala, Uganda.MethodsWe conducted a cross-sectional study between...

Assessing the Acceptability of a Mindfulness-Based Cognitive Therapy Intervention for African-American Women Living with HIV/AIDS.

African-American HIV-seropositive women are at elevated risk for depressive symptoms compared to their seropositive counterparts. Depressive symptoms have been linked to HIV/AIDS-related health predictors and outcomes such as medication and care adherence, and viral load. Project UPLIFT, a mindfulness-based cognitive therapy intervention originally designed for persons with epilepsy has been shown effective to reduce depressive and anxiety symptoms. Focus groups were conducted to assess the appropriateness and acceptability of UPLIFT for African-American HIV-seropositive women and to obtain feedback on needed modifications. The focus groups, including cisgender and transgender African-American HIV-seropositive women, revealed, while well received, modifications should include lowering the reading level of content and altering specific mindfulness-based exercises to make them relevant and acceptable to the target population. This qualitative work demonstrates UPLIFT could be a promising avenue to improve the mental health of African-American HIV-seropositive women, a group for which mindfulness interventions had not been previously considered. SIGNIFICANCE: Mindfulness-based interventions have been found effective in reducing depression, anxiety, and chronic pain. Further, it has been used for groups living with chronic illness, particularly HIV/AIDS. It has helped to improve mental and behavioral health, as well as increase CD4 count and reduce viral load for some samples of people living with HIV/AIDS. African-American women living with HIV/AIDS are especially vulnerable to poor mental and behavioral health given their experience of mental illness and hesitancy to engage mental healthcare. Though used for other groups of people living with HIV/AIDS, mindfulness-based cognitive therapy has not previously been considered for this population. This study explored the acceptability and feasibility of an MBCT intervention for this group. The data suggests that this intervention could be potentially useful in improving the mental health of this population, and includes suggestions for making the intervention culturally relevant.

Examining engagement in care of women living with HIV in South India

HIV seropositive adherence-challenged women, who reported being on ART for at least four months were interviewed. Data on healthcare history, anti-retroviral therapy, clinic visits, doctor communication, disclosure and fear of stigma were collected. Better engagement in care was significantly more likely among older women, ≥ 10 years of education, higher income, HIV status disclosure to family, with higher community stigma fears and fewer healthcare access barriers. To promote retention, women may be encouraged to consider disclosing their HIV serostatus to supportive household members. A variety of possible interventions to overcome the prevalent barriers to care are provided.

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

Release of Soluble Insulin Receptor From Neurons by Cerebrospinal Fluid From Patients With Neurocognitive Dysfunction and HIV Infection.

Previously, we found that high levels of soluble insulin receptor (sIR) in the cerebrospinal fluid (CSF) of an HIV-infected women cohort were associated with the presence and severity of HIV-associated neurocognitive disorders (HAND). In this study we investigated if CSF from this population, HIV-1 Tat, and selected cytokines induces sIR secretion from human neuronal cells. Twenty-three (23) HIV-seropositive women stratified by cognitive status and five HIV- seronegative women were evaluated. Soluble IR levels were measured in the extracellular medium of neuronal cells (SH-SY5Y) that were exposed (for 24 h) to the CSF of patients. The levels of sIR, HIV-1 Tat, and cytokine levels (IL-2, IL4, IL-6, IFNγ, TNFα, and IL-10) were quantified in the CSF of participants by ELISA and flow cytometry. Neuronal secretion of sIR was measured after exposure (24 h) to HIV-1 Tat (0.5–250 nM), or specific cytokines. The effects of TNFα and HIV-1 Tat on sIR secretion were also evaluated in the presence of R7050 (TNFα antagonist; 10 nM). Neurons exposed to the CSF of HIV-infected women had higher sIR levels according to the severity of neurocognitive impairment of the participant. Increased CSF sIR levels were associated with the presence and severity of HAND and were positively correlated with CSF HIV-1 Tat levels in HIV-infected women with cognitive impairment. CSF levels of IL-2, IFNγ, and TNFα were significantly increased with HAND. However, only TNFα (5 pg/mL) and HIV-1 Tat (100 nM) induced a significant increase in neuronal sIR secretion after 24 h exposure, an effect that was antagonized when each were combined with R7050. Our data suggests that TNFα and HIV-1 Tat from the CSF of HIV-infected women may regulate the secretion of sIR from neuronal cells and that the effect of HIV-1 Tat on sIR secretion may depend on TNFα receptor activation.

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

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 Maternal HIV Infection on Treatment with HAART on Neonatal Birth Weight and Other Anthropometry: A Cohort Study of HIV Sero-Positive Women in Enugu, South-East Nigeria

Effect of Maternal HIV Infection on Treatment with HAART on Neonatal Birth Weight and Other Anthropometry: A Cohort Study of HIV Sero-Positive Women in Enugu, South-East Nigeria