Human Immunodeficiency Virus Infected Pregnant Women Research Articles

What is the influence of preeclampsia on vertical transmission of HIV?

In a temporal perspective, the first studies regarding the influence of human immunodeficiency virus (HIV) on the occurrence of preeclampsia (PE) indicated that in HIV-infected pregnant women, PE would be reduced due to the immunological and endothelial changes subsequent to viral infection. However, with the advent of highly active antiretroviral therapy (HAART) and the possibility of minimizing or eliminating immunological and inflammatory changes, the risk of developing PE in HIV-infected pregnant women would be expected to increase (Machado. J Infect 2014;68:572–80). Even though a meta-analysis did not confirm this association (Brown. J Acquir Immune Defic Syndr 2015;70:91–8), a more recent publication supported this assertion (Sansone. Obstet Gynecol 2016;127:1027–32). There are a great number of studies on HIV infection in pregnant women in association with PE; however, only a few evaluated the influence of PE on the rate of HIV vertical transmission (VT). It is known that PE is a systemic disorder with abnormal activation of immune and inflammatory responses including in the placenta. These changes resemble the response to HIV infection and impact placental expression of tissue receptors involved in VT of HIV. Ultimately, knowledge of the influence of PE on expression of these receptors could influence strategies to prevent and control PE and strengthen measures to reduce the VT of HIV. Dorsamy et al. precisely assessed whether PE alters the expression of receptors in the placenta and umbilical cord that are linked to intrauterine transmission of HIV. They detected markers of HIV infection (p. 24, CD4 lymphocytes, CCR5 and ICAM-2) in trophoblast and umbilical cord tissue from both normotensive and preeclamptic HIV-infected pregnant women. The expression of CCR5 was significantly increased in both preeclamptic and normotensive HIV-infected women, showing that PE can increase the risk of VT of HIV. Increased expression of CCR5 on trophoblastic membrane coupled with the expression of CD4 receptor can also increase vulnerability to HIV infection. It was further observed that ICAM-2 had a significantly higher expression in placental tissue of HIV-negative preeclamptic women when compared with the HIV-positive groups under HAART, supporting that HAART protects against the VT of HIV. Conversely, improvements in immunological parameters in HIV-infected pregnant women and the high levels of HIV receptors in syncytiotrophoblast of normotensive pregnant women possibly exacerbate the risk of PE. These findings justify the need to continue use of antiretroviral drugs for the mother during her prenatal care, and during labour, delivery and the postpartum period (Luzuriaga, Mofenson. N Engl J Med 2016;374:761–70). Furthermore, it also indicates the need for special monitoring of pregnant women on HAART, including blood pressure evaluations at short intervals, to optimize specific screening and prophylactic care for PE (O'Gorman. BMJ Open 2016;6:e011801). None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Severe Vitamin D Deficiency in Human Immunodeficiency Virus-Infected Pregnant Women is Associated with Preterm Birth.

Background Low maternal vitamin D has been associated with preterm birth (PTB). Human immunodeficiency virus (HIV)-infected pregnant women are at risk for PTB, but data on maternal vitamin D and PTB in this population are scarce. Methods In a cohort of Latin American HIV-infected pregnant women from the National Institute of Child Health and Human Development International Site Development Initiative protocol, we examined the association between maternal vitamin D status and PTB. Vitamin D status was defined as the following 25-hydroxyvitamin D levels: severe deficiency (< 10 ng/mL), deficiency (10-20 ng/mL), insufficiency (21-29 ng/mL), and sufficiency (≥30 ng/mL). PTB was defined as delivery at < 37 weeks' gestational age (GA). Logistic regression was used to assess the association between maternal vitamin D status and PTB. Results Of 715 HIV-infected pregnant women, 13 (1.8%) were severely vitamin D deficient, 224 (31.3%) were deficient, and 233 were (32.6%) insufficient. Overall, 23.2% (166/715) of pregnancies resulted in PTB (median GA of PTBs = 36 weeks [interquartile range: 34-36]). In multivariate analysis, severe vitamin D deficiency was associated with PTB (odds ratio = 4.7, 95% confidence interval: 1.3-16.8]). Conclusion Severe maternal vitamin D deficiency is associated with PTB in HIV-infected Latin American pregnant women. Further studies are warranted to determine if vitamin D supplementation in HIV-infected women may impact PTB.

Risk of Preeclampsia in Human Immunodeficiency Virus-Infected Pregnant Women.

To evaluate the risk of preeclampsia in pregnant women with human immunodeficiency virus (HIV). This is a 26-year population-based retrospective cohort study. Human immunodeficiency virus-infected pregnant women were compared with a HIV-negative comparison group. The primary outcome was the incidence of preeclampsia. We planned subgroup analysis according to antiretroviral therapy. A total of 84,725 women were included in the analysis, of whom 453 were HIV-infected and 84,272 HIV-negative. Of the 453 HIV-infected women, 301 (66.4%) received highly active antiretroviral therapy (HAART group) during pregnancy, whereas 152 (33.6%) did not. After adjusting for confounders, we found that HIV-infected women had a significantly higher risk of preeclampsia (10.2% compared with 4.1%; adjusted odds ratio [OR] 2.68, 95% confidence interval [CI] 1.96-3.64), preeclampsia with severe features (4.0% compared with 2.0%; adjusted OR 2.03, 95% CI 1.26-3.28), early-onset (3.5% compared with 1.4%; adjusted OR 2.50, 95% CI 1.51-4.15) and late-onset preeclampsia (6.6% compared with 2.6%; adjusted OR 2.64, 95% CI 1.82-3.85), and preterm birth at less than 37 weeks of gestation (11.0% compared with 4.7%; adjusted OR 2.50, 95% CI 1.86-3.37) compared with the comparison group. Human immunodeficiency virus-infected women who received HAART had a significantly higher risk of preeclampsia compared with women without HIV (13.0% compared with 4.1%; adjusted OR 3.52, 95% CI 2.51-4.94) and compared with the non-HAART group (13.0% compared with 4.6%; adjusted OR 3.08, 95% CI 1.34-5.07). The non-HAART group had a similar risk compared with women without HIV (4.6% compared with 4.1%; adjusted OR 1.14, 95% CI 0.53-2.44). Human immunodeficiency virus-infected women had an increased risk of preeclampsia. Some of this risk seems to be linked to HAART.

Infecţia HIV la nou-născut şi sugar – diagnostic de laborator

AIDS was reported in the pediatric population for the first time in 1982 in the USA by pediatricians who hardly managed to convince those responsible for childcare, because it can also occur in this population segment. Thanks to efforts for disease recognition in the pediatric population, scientists have been able to provide support and children infected with human immunodeficiency virus (HIV) receive the same treatment protocol as adults. Early detection of HIV infection in pregnant women leads to the possibility for starting a treatment to prevent HIV transmission from mother to child. The ELISA test has a high sensitivity and is indicated for HIV screening and Western Blot test has highly specificity and confirming the HIV infection.

Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study.

This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV type found in both samples). An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection (20%). A low CD4+T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting.

Women and HIV infection, current status of the problem

The increase in the number of people infected with the human immunodeficiency virus (HIV) and increasing the share of women among them, as well as annual growth in the number of births to HIV-infected women define extraordinary relevance for the prevention of HIV transmission from mother to child. Tactics to prevent HIV transmission from mother to child is determined by a set of epidemiological, clinical and laboratory parameters and selected for each individual woman after consultation with the appropriate professionals. It is shown that the most important factor affecting the likelihood of HIV transmission from mother to fetus and child, is the concentration of virus in the blood of women (the so-called viral load - VL) during pregnancy and childbirth, so it is important to achieve it undetectable levels as early as possible in pregnancy. As the activities carried out in the framework of this prevention, the importance of timely diagnosis of HIV infection and identifying high risk of HIV infection in pregnant women, chemoprophylaxis (CP) carried out with the help of antiretroviral drugs (ARVs), woman and child, the tactics of pregnancy and childbirth, and also keeping the child in the first half year of life, including avoidance of breastfeeding. Appointment ARV HIV-infected women may be necessary not only to prevent infection of the child, but also to treat the woman. In appointing ART necessary to minimize potential adverse effects of ARV drugs on the fetus, which is especially important in the I trimester of pregnancy. Therefore, the starting date of receiving ARVs in pregnant should be optimal from the point of view of the effectiveness of the treatment of women, the effectiveness of prophylaxis of infection of the child and the safety of the fetus.

Some hematological and hemorheological changes in HIV-infected pregnant women on highly active antiretroviral therapy

Background: The overwhelming impact the Human Immunodeficiency Virus (HIV) has on the world is undeniable. With the introduction of highly active antiretroviral therapy (HAART), HIV/AIDS has changed from a killer disease to a treatable chronic infection. However, HAART may be associated with some blood changes. Objectives: The aim of this study is to evaluate the effect of HAART on some haematological and haemorrheological indices in HIV infected pregnant women at different trimesters. Methods: This study was carried out at the ante-natal clinic of the University of Benin Teaching Hospital from April 2013 to February, 2014. Ethical approval was obtained from the ethics and research committee of the University of Benin Teaching Hospital. Fifty (50) HIV-seropositive pregnant women on HAART and 50 HIV-seropositive pregnant women not on HAART as controls were recruited. The mean age of these women was 29 years. Blood was sampled from both test and control subjects for whole blood viscosity (WBV) by Reid and Ugwu method, platelet, while blood cell count, haemoglobin estimation and erythrocyte sedimentation rate were done by methods described by Dacie and Lewis. Results: In the first trimester there were no significant changes in Hb, WBC and WBV ( P > 0.05) between test and control subjects, while in the second trimester there was a significant decrease in platelet counts ( P > 0.05). In the third trimester of gestation WBC also increased significantly ( P Conclusion: Haematological and haemorheological activity differs in pregnancy and the introduction of HAART further predisposes these women to bleeding episodes.

Effect of antiretroviral drugs on prolactin in HIV infected pregnant women

The world has finally settled living with Human immunodeficiency Virus (HIV) with no cure discovered so far. Yong people with HIV infection under HIV management drugs get married and eventually end up being pregnant and bearing babies. The need therefore to investigate the effect of HIV infection and antiretroviral drugs on body chemistry especially the hormones concerned with pregnancy and lactation cannot be over emphasized as this is important to intervene when necessary for the overall benefit for the mother and child. We investigated the effect of anti-retroviral drugs and human immune deficiency virus (HIV) infection on prolactin production and stimulation in HIV-infected pregnant women. A total of 120 subjects participated in the study. Sixty (group 1) of these subjects were HIV seropositive pregnant women who commenced treatment with zidovudine in combination with lamivudine, that is highly anti-retroviral therapy (HAART) at 2nd trimester. The 2nd group made up of 60 HIV seronegative pregnant women who received no drug and as control to the study. The blood samples of both groups were collected at the beginning of the second and at the end of the third trimesters. For group 1 (seropositive pregnant women), the blood collection was done just before commencingthe HAART treatment. The prolactin level of HIV seropositive pregnant women were significantly (P &lt; 0.05) lower than the HIV seronegative pregnant women at the 2nd trimester. Also, the prolactin level of HIV seropositive pregnant women at 2nd trimester was not significantly increased (P&gt; 0.05) compared with third trimester level. The reverse was the case with HIV seronegative pregnant women where prolactin level of 3rdtrimester was significantly increased when compared with 2nd trimester. HIV infection has prolactin suppressive effect on pregnant women and HAART treatment did not significantly raise prolactin level.Keywords: Prolactin, pregnancy, HIV, highly active retroviral therapy (HAART).

British HIV Association guidelines for the management of HIV infection in pregnant women 2012 (2014 interim review).

British HIV Association guidelines for the management of HIV infection in pregnant women 2012 (2014 interim review).

The Age, Education, and Occupation Characteristics is not Associated with Human Immunodeficiency Virus (HIV) Infection in Pregnant Mothers

Abstract&#x0D; Objective: To know the relation ship between age, education and occupation on the pregnant women and the HIVstatus of the husband against the risk of being infected with HIV.&#x0D; Method: This was an unpaired case cont rol study perform ed in the Obstetrics and Gynecology Department of Sanglah Hospital, Denpasar, from October to November 2011. The subjects were pregnant women who were willing to particip ate in the research, which were grouped into HIV-infected case and control group. Diagnosis of HIV was based on rapid test The data was analyzed using ChiSquar e test with the help of SPSS version 17.0&#x0D; Result: There was fifty subjects consisting of 25 subjects in the case group and 25 subjects in contr ol group we obtained that the risk of HIV-infected pregnant women in the old vs young age, low vs higher education, and occupations at risk vs not at risk is not significant in the two groups. Each Odds ratio is 0.35 (CI =95% 0.08-1.55; P = 0.16),0.85 (CI=95% 0.28-2.59; P =0.77), and 2.09 (CI=95% 0.1824.62; P =1.00). Meanwhile, the odds ratio of the husband HIV status was 12.67 (CI =95% 3.31-48.50; P =0.01).&#x0D; Conclusion: Husband s infected with HIVincreases the risk of HIV in pregnant women 12 times greater than if the husband was not infected with HIV. Wher eas, age, education, and th e occupation of mothers is not a risk factor for the occurrence of HIV infection in pregnant women.&#x0D; Keywords: age, education, husband HIV statu s, occupation and pregnant women infected with HIV.

Pattern of sexually transmitted infections in human immunodeficiency virus positive women attending antenatal clinics in north-central Nigeria

Background: Sexually transmitted infections (STIs) are prevalent during pregnancy and may have adverse sequalae in both mother and fetus. Interactions between these infections and human immunodeficiency virus (HIV) synergize and may cause adverse pregnancy outcomes and reverse the gains of prevention of mother to child transmission of HIV. Objectives: The objective of this study is to determine the prevalence of candidiasis, trichomoniasis, gonococcal infection, syphilis, and bacterial vaginosis in HIV pregnant women and compare with HIV negative controls. Materials and Methods: A case-control study was conducted during the period from April to December 2010 at the Department of Obstetrics/Gynecology of University of Ilorin Teaching Hospital and three Primary Health Centers in Ilorin. A total of 160 HIV positive pregnant women attending antenatal clinics were recruited, along with the same number of HIV negative matched controls. A structured proforma was used to collect information from patients, vaginal examination was performed and samples were taken from the endocervix and the posterior vaginal fornix with swab sticks. Results: STIs were recovered from 142 women, giving overall prevalence of 44.4%. HIV infected women had a higher prevalence (60%) compared to uninfected (28.8%). The most prevalent STI was vaginal candidiasis (29.1%), followed by bacterial vaginosis (9.7%), and trichomoniasis (5.6%). The prevalence of candidiasis, bacterial vaginosis, and trichomoniasis was higher among HIV positive pregnant women compared to HIV negative controls (P < 0.05). No woman had syphilis or gonorrhea. Conclusion: The prevalence of candidiasis, bacterial vaginosis and trichomoniasis was higher in HIV infected pregnant women compared to uninfected. Routine screening of HIV infected pregnant women for these organisms is advocated.

Human Immunodeficiency Virus (HIV) types Western blot (WB) band profiles as potential surrogate markers of HIV disease progression and predictors of vertical transmission in a cohort of infected but antiretroviral therapy naïve pregnant women in Harare, Zimbabwe

BackgroundExpensive CD4 count and viral load tests have failed the intended objective of enabling access to HIV therapy in poor resource settings. It is imperative to develop simple, affordable and non-subjective disease monitoring tools to complement clinical staging efforts of inexperienced health personnel currently manning most healthcare centres because of brain drain. Besides accurately predicting HIV infection, sequential appearance of specific bands of WB test offers a window of opportunity to develop a less subjective tool for monitoring disease progression.MethodsHIV type characterization was done in a cohort of infected pregnant women at 36 gestational weeks using WB test. Student-t test was used to determine maternal differences in mean full blood counts and viral load of mothers with and those without HIV gag antigen bands. Pearson Chi-square test was used to assess differences in lack of bands appearance with vertical transmission and lymphadenopathy.ResultsAmong the 64 HIV infected pregnant women, 98.4% had pure HIV-1 infection and one woman (1.7%) had dual HIV-1/HIV-2 infections. Absence of HIV pol antigen bands was associated with acute infection, p = 0.002. All women with chronic HIV-1 infection had antibody reactivity to both the HIV-1 envelope and polymerase antigens. However, antibody reactivity to gag antigens varied among the women, being 100%, 90%, 70% and 63% for p24, p17, p39 and p55, respectively. Lack of antibody reactivity to gag p39 antigen was associated with disease progression as confirmed by the presence of lymphadenopathy, anemia, higher viral load, p = 0.010, 0.025 and 0.016, respectively. Although not statistically significant, women with p39 band missing were 1.4 times more likely to transmit HIV-1 to their infants.ConclusionAbsence of antibody reactivity to pol and gag p39 antigens was associated with acute infection and disease progression, respectively. Apart from its use in HIV disease diagnosis, WB test could also be used in conjunction with simpler tests like full blood counts and patient clinical assessment as a relatively cheaper disease monitoring tool required prior to accessing antiretroviral therapy for poor resource settings. However, there is also need to factor in the role of host-parasite genetics and interactions in disease progression.

Safety and Efficacy of Fosamprenavir in Human Immunodeficiency Virus-infected Pregnant Women

To the Editors: In the United States, highly active antiretroviral therapy (HAART) is recommended during pregnancy to reduce the risk of perinatal transmission of human immunodeficiency virus (HIV) and to improve the health of the mother.1 Many HAART regimens used during pregnancy include a protease inhibitor.1 Although the protease inhibitor fosamprenavir has been available since 2003, no prospective data to date have been presented regarding its safety and efficacy when used during pregnancy. COL108577 was a retrospective, observational case series evaluating mother and infant outcomes for all HIV-positive pregnant women, from one clinical practice, who delivered while taking fosamprenavir. Patients' charts dating from October 2003 to date were reviewed. Given the expected sample size of approximately 10 mother-infant pairs, no statistical testing was planned, and results of abstracted data were intended to be descriptive. Baseline was defined as the last observation before fosamprenavir initiation, whereas the delivery value was the observation at or closest to delivery. Data were available for 9 mother-infant pairs. Median baseline age of the mothers was 33 years (range, 20–43). Six women were naive to HAART at baseline. In addition to fosamprenavir, HAART regimens included boosting with ritonavir (n = 7) and initial nucleoside reverse transcription inhibitor backbones of zidovudine/lamivudine (n = 6), tenofovir/emtricitabine (n = 1), didanosine/emtricitabine (n = 1), and abacavir/lamivudine (n = 1). During the observation period, 1 woman switched her zidovudine/lamivudine backbone to tenofovir/emtricitabine. Improvements were observed both in viral load and in CD4+ T-cell count consistently across the study cohort (Table 1). Compared with baseline, delivery viral loads decreased for each of the 8 women who had started with a detectable level; and for the 1 woman with an undetectable viral load (<50 copies/mL) at baseline, her viral load remained undetectable at delivery. Additionally, CD4+ T-cell counts increased for all 9 women. No hepatic, renal, or pancreatic abnormalities were seen in the mothers. The regimens were well-tolerated. Delivery modes were as follows: 4 vaginal, 4 scheduled c-section, and 1 emergent c-section. Median gestational age was 37 6/7 weeks (range, 35 4/7–42).TABLE 1: Maternal Characteristics and Outcomes (n = 9)For infants outcomes, the median of the 3 APGAR score readings was 8.67 (range, 7.33–9.00). Median birth weight and height were 3041 g (range, 2175–4216) and 51 cm (range, 43.8–58.4), respectively. CNS abnormalities, sometimes of concern with sulfonamide-containing products, were not observed in the infants, nor were any adverse events attributed to fosamprenavir. To date, all infants (n = 9) have tested negative for HIV by polymerase chain reaction. In conclusion, this small study showed that fosamprenavir-based HAART was well-tolerated in a cohort of pregnant women, with most of the women achieving favorable immunologic and virologic responses comparable to those reported with other protease inhibitor-based regimens administered during pregnancy.2–5 In infants, good birth outcomes and no significant adverse events were reported, and no mother-to-child transmission of HIV was detected. Claudia Martorell, MD, MPH, FACP The Research Institute [email protected] Eileen Theroux, RN, BSN Department of Pediatrics Baystate Medical Center Arlene Bermudez, AS The Research Institute Springfield, MA Jane Garb, MS Health Geographics Program Baystate Medical Center Springfield, MA Debra Kronschnabel, PharmD ViiV Healthcare Research Triangle Park, NC Katrina Oie, PhD GlaxoSmithKline Research Triangle Park, NC

Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women

Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women

Performance of an automated human immunodeficiency virus (HIV) antigen/antibody combined assay for prenatal screening for HIV infection in pregnant women

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Pregnancy and Optimal Care of HIV‐Infected Patients

Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission, universal testing for HIV infection in pregnant women is ideal. In the United States and other developed countries, great strides have been made toward decreasing the risk of HIV transmission to infants to <2% with use of a combination of highly active antiretroviral therapy during the antepartum period and during labor and delivery, scheduled cesarean section when appropriate, avoidance of breast-feeding, and 6 weeks of zidovudine prophylaxis for infants. The continuation of antiretroviral therapy after delivery depends on the needs of the mother with regard to treatment of her own health. In resource-limited countries, where simplified and shortened courses of antiretroviral regimens have been used, reduction in mother-to-child transmission has also been shown, although not as effectively as that with highly active antiretroviral therapy. In these settings, exclusive breast-feeding for 6 months is recommended to reduce the risk of postnatal transmission.

Geophagy (Soil-eating) in Relation to Anemia and Helminth Infection among HIV–Infected Pregnant Women in Tanzania

Geophagy, the regular and deliberate consumption of soil, is prevalent among pregnant women in sub-Saharan Africa. We examined the associations of geophagy with anemia and helminth infection among 971 human immunodeficiency virus (HIV)-positive pregnant women in Tanzania. About 29% of pregnant women regularly consumed soil. Occupation, marital status, and gestational age were associated with geophagy. Ascaris lumbricoides infection was associated with the prevalence of geophagy (adjusted-prevalence ratio 1.81; 95% confidence interval [CI] = 1.37-2.40); however, hookworm, Trichuris trichiura, and Strongyloides stercoralis showed no association. Anemia and red blood cell characteristics suggestive of iron deficiency were strongly correlated with geophagy at baseline. In longitudinal analyses, we found evidence suggesting that soil consumption may be associated with an increased risk of anemia (adjusted-relative risk 1.16; 95% CI = 0.98-1.36) and a lower hemoglobin concentration (adjusted-mean difference -3.8 g/L; 95% CI [-7.3, -0.4]). Pregnant women should be informed about the potential risks associated with soil consumption.

The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community

BackgroundA complex interaction exists between tuberculosis (TB) and human immunodeficiency virus (HIV) infection at an individual and community level. Limited knowledge about the rate of HIV infection in TB patients and the general population compromises the planning, resource allocation and prevention and control activities. The aim of this study was to determine the rate of HIV infection in TB patients and its correlation with the rate HIV infection in pregnant women attending antenatal care (ANC) in Southern Ethiopia.MethodsAll TB patients and pregnant women attending health institutions for TB diagnosis and treatment and ANC were consecutively enrolled in 2004 – 2005. TB diagnosis, treatment and HIV testing were done according to the national guidelines. Blood samples were collected for anonymous HIV testing. We used univariate and multivariate logistic regression analysis to determine the risk factors for HIV infection and linear regression analysis to determine the correlation between HIV infection in TB patients and pregnant women.ResultsOf the 1308 TB patients enrolled, 226 (18%) (95%CI: 15.8 – 20.0) were HIV positive. The rate of HIV infection was higher in TB patients from urban 25% (73/298) than rural areas 16% (149/945) [AOR = 1.78, 95%CI: 1.27–2.48]. Of the 4199 pregnant women attending ANC, 155 (3.8%) [95%CI: 3.2–4.4] were HIV positive. The rate of HIV infection was higher in pregnant women from urban (7.5%) (80/1066) than rural areas (2.5%) (75/3025) [OR = 3.19, 95% CI: 2.31–4.41]. In the study participants attending the same health institutions, the rate of HIV infection in pregnant women correlated with the rate of HIV infection in TB patients (R2 = 0.732).ConclusionThe rate of HIV infection in TB patients and pregnant women was higher in study participants from urban areas. The rate of HIV infection in TB patients was associated with the prevalence of HIV infection in pregnant women attending ANC.

Management of Human Immunodeficiency Virus–Infected Pregnant Women at Latin American and Caribbean Sites

Management of Human Immunodeficiency Virus–Infected Pregnant Women at Latin American and Caribbean Sites

Toxoplasmosis

Toxoplasmosis