Immunodeficiency Virus Infected Pregnant Women Research Articles

Mycoplasma hominis increases the risk for Ureaplasma parvum infection in Human immunodeficiency virus infected pregnant women.

Mycoplasma hominis and Ureaplasma parvum have been recently linked to sexually transmitted diseases and other conditions. There are a limited number of studies conducted on South African pregnant women that have assessed the prevalence and risk factors for genital mycoplasmas. This study included 264 HIV infected pregnant women attending the King Edward VIII antenatal clinic in eThekwini, South Africa. DNA was extracted using the PureLink Microbiome kit and pathogens were detected using the TaqMan Real-time PCR assays. The statistical data analysis was conducted in a freely available Statistical Computing Environment, R software, version 3.6.3 using the RStudio platform. The prevalence of M. hominis and U. parvum, was 215/264 (81.4%), and 203/264 (76.9%), respectively. In the M. hominis positive group, a significantly (p = 0.004) higher proportion, 80.5% tested positive for U. parvum infection when compared to 61.2% among the M. hominis negative. Of the U. parvum positive women, a significantly (p = 0.004) higher proportion of women (85.2%) tested positive for M. hominis when compared to 68.9% among the U. parvum negative. In the unadjusted and adjusted analysis, being M. hominis positive increased the risk for U. parvum by approximately 3 times more (p = 0.014) and 4-fold (p = 0.008), respectively. This study showed a significant link between M. hominis and U. parvum infection. To date, there are a limited number of studies that have investigated M. hominisbeing a risk factor for U. parvum infection. Therefore, the data presented in the current study now fills in this gap in the literature.

Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study

BackgroundPeople living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little is known about the epidemiology of tuberculosis among pregnant women infected with the virus, particularly in resource-limited settings where the burdens of these infections are substantial. Hence, this study aimed to estimate tuberculosis incidence and identify its risk factors among human immunodeficiency virus infected pregnant women in northwest Ethiopia. MethodsAn institutional-based retrospective follow-up study was conducted among pregnant women who were enrolled in option B+ prevention of mother to child transmission service between June 2013 and April 2021 in Pawe district. The Kaplan–Meier survival curve and Weibull regression model were used to estimate survival probability and identify risk factors of tuberculosis, respectively. The best model between the Cox and parametric models was chosen using the Akaike and Bayesian information criteria. ResultOut of 289 human immunodeficiency virus infected pregnant women included in the final analysis, 29 (10.03 %) developed active tuberculosis. The overall incidence of tuberculosis was 17.4 per 1000 person-months of observation (95 % CI: 12.1, 25.1). Lack of isoniazid preventive therapy (AHR: 6.68, 95 % CI: 2.67, 16.7), new enrollment to care (AHR: 2.62, 95 % CI: 1.14, 6.03), under-nutrition (AHR: 5.09, 95 % CI: 2.02, 12.83), low CD4 count (AHR: 2.61, 95 % CI: 1.01, 6.78), and suboptimal antiretroviral therapy adherence (AHR: 3.17, 95 % CI: 1.46, 6.86) were predictors of tuberculosis among HIV-positive pregnant women. ConclusionThis study found a high incidence of tuberculosis among human immunodeficiency virus infected pregnant women. Thus, strengthening the provision of tuberculosis preventive therapy, reinforcing adherence support, and controlling under-nutrition should be considered to decrease the risk of tuberculosis.

Seroprevalence of Toxoplasmosis among Human Immunodeficiency Virus infected pregnant women in Abuja Teaching Hospital, Nigeria

Introduction. Toxoplasmosis is a neglected parasitic infection that has economic and epidemiological significance. Data on toxoplasmosis seroprevalence among Human Immunodeficiency Virus (HIV) infected pregnant women may be of obstetric and neonatal concern. Aim. The study was designed to determine the seroprevalence of Toxoplasmosis and associated risk factors in HIV-positive pregnant women attending the University of Abuja Teaching Hospital, Abuja, Northcentral Nigeria. Material and methods. This was a hospital-based cross-sectional study. A total of 160 HIV seropositive pregnant women were recruited. Blood samples were collected and tested for anti-T. gondii IgM and IgG using Enzyme Linked Immunosorbent Assay (ELISA). Structured questionnaires were used to collate the sociodemographic variables of participants. Results. Out of the 160 of HIV seropositive pregnant women, the seroprevalence anti-T. gondii IgG and IgM were 29.4% and 4.4%, respectively. There was no significant association between anti-T. gondii and all sociodemographic variables studied (p>0.05). Conclusion. The overall result of this study revealed that the majority of pregnant women were exposed to toxoplasmosis much earlier in life. Hence, these findings will assist obstetricians and gynecologists in the early diagnosis and management of Toxoplasma gondii infection in pregnant women, especially HIV coinfected ones with IgM seropositivity.

Mid-arm muscle area and anthropometry predict low birth weight and poor pregnancy outcomes in Tanzanian women with HIV

BackgroundAn observational study was conducted to examine the role of maternal anthropometry, including mid-arm muscle area (MAMA) and others, as risk factors for low birth weight (LBW), small for gestational age (SGA) and preterm births in human immunodeficiency virus (HIV) infected pregnant women. HIV-positive women (N = 2369), between 12 and 32 weeks gestation were followed through delivery in Tanzania, from 2003 to 2008. Participants were women enrolled in a randomized, double-blind, placebo-controlled, clinical trial who delivered live births.MethodsBinomial regression analysis was used to evaluate the association of maternal nutritional indicators of MAMA, mid-upper arm circumference (MUAC), body mass index (BMI) and maternal weight with LBW, SGA and preterm in multivariate analysis.ResultsHigher MAMA was associated with a 32% lower risk of LBW compared to lower measurements (RR = 0.68, 95% CI = 0.50–0.94). Similar protective associations were noted for higher BMI (RR = 0.58, 95% CI = 0.42–0.79); maternal weight (RR = 0.50, 95% CI = 0.36–0.69) and MUAC (RR = 0.62, 95% CI = 0.45–0.86). Higher MAMA was also associated with lower risk of SGA (RR = 0.78, 95% CI = 0.68–0.90) and marginally associated with preterm (RR = 0.85, 95% CI = 0.69–1.04). Beneficial associations of MUAC, BMI and maternal weight with SGA and preterm were also observed.ConclusionMAMA performs comparably to MUAC, maternal weight and BMI, as a predictor of LBW and SGA in HIV-infected women. The possible role of MAMA and other indicators in screening HIV positive women at risk of adverse pregnancy outcomes should be investigated.

Attitudes and perceptions of pregnant women towards the use of Anti-Retroviral Therapy in Nigeria

BackgroundMother-to-child transmission of Human Immunodeficiency Virus continues to be a major problem in Nigeria. Despite several initiatives, the number of infected pregnant women receiving Anti-Retroviral Therapy to prevent mother-to-child transmission of the virus remains low in Nigeria. Evidence suggests that attitudes and perceptions of the pregnant women influence their use of Anti-Retroviral Therapy. AimTo understand the attitudes and perceptions of Human Immunodeficiency Virus infected pregnant women towards the use of Anti-Retroviral Therapy for prevention of mother-to-child transmission in Nigeria. MethodTwenty four Human Immunodeficiency Virus infected pregnant women were purposively selected from antenatal clinics. Women’s attitudes and perceptions towards the use of Anti-Retroviral Therapy were explored using semi-structured in-depth interviews conducted in May/June 2016. All interviews were recorded, transcribed and analysed using thematic approach. FindingsOverall, participants reflected a positive attitude about using Anti-Retroviral Therapy to prevent mother-to-child transmission and perceived the treatment as beneficial. The main themes identified included: perceived benefits of Anti-Retroviral Therapy; barriers to using Anti-Retroviral Therapy; threat from the susceptibility to the illness and the severity; perceived roles in treatment; and the negative behaviours of healthcare providers. ConclusionThe findings provide useful insights to inform Nigeria’s health policies on Anti-Retroviral Therapy. There is a need to educate the women on the benefits of the treatment as well as how they can cope with side effects and the daily regimen of the therapy during pregnancy. The findings also indicate the need for training healthcare providers on facilitative patient-provider relationship.

Birth Outcomes in HIV-1-Infected Women Receiving Highly Active Antiretroviral Therapy (HAART) Prior to Conception versus During Pregnancy in Yaoundé, Cameroon

Objective: To assess the impact of antiretroviral on birth outcome according to the timing of antiretroviral initiation in relation to pregnancy in human immunodeficiency virus (HIV) infected pregnant women. Methods: Cross sectional study, observational, in a single referral site, the Centre Hospitalier d’ESSOS of Yaounde from 2008 to 2013. Babies born to HIV positive mothers under HAART prior to conception were compared with those initiating treatment during pregnancy. Main measurement: rate of preterm birth (PTB) defined as gestational age<37 weeks at birth and low birth weight (LBW)<2500 g. Results: We included 617 newborn babies. Almost 96% of their mothers were taking antiretroviral drugs free of protease inhibitor. Overall rate of LBW was at 11.6% and PTB at 9.7 %. In bivariate analysis, PTB were similarly rated in preconception HAART(8.1%) versus during pregnancy (10.1%), odd ratio (1.22: 0.6-2.5, p=0.90); in ART started during pregnancy, the PTB frequency was analogous, irrespective of the moment of antiretroviral therapy (ART) started before 28 weeks (10.9%), or after (9%), p=0.9. In addition, LBW rates were registered at 11.7% prior to pregnancy versus 11.6% after conception (p=0.9). The ART started during pregnancy <28 weeks pregnancy was almost twice associated to a higher risk of LBW odd ratio (1.87: 1.02-3.44, p<0.05). Conclusion: ART prior to conception mainly free of protease inhibitor does not increase the risk of PTB or LBW in Yaounde, Cameroon.

Haematological Changes in Human immunodeficiency Virus Infected Pregnant Women in Benin City, Nigeria

Human immunodeficiency virus (HIV) pandemic is an undisputable reality of our time with socio-political implications and unrelenting morbidity and mortality profiles. The epidemic prevalence rate in Nigeria is very high. One hundred and fifty cases of women attending antenatal clinic in the University of Benin Teaching Hospital were reviewed in a prospective study. These comprised 50 HIV seropositives who had just been diagnosed of having HIV infection but had not commenced anti-retroviral therapy (ARVT); 50 HIV seropositives who were on ARVT and 50 age- and parity-matched HIV seronegatives as controls. The parameters investigated were haematocrit volume (PCV), determined by Hawskley micro-capillary centrifugation, the haemoglobin (Hb) value by the cyanmethaemoglobin method, total leucocyte and platelet counts were done by standard methods. A differential leucocyte count was also done by the thin blood film method, stained with Leishman stain and examined microscopically. The erythrocyte sedimentation rate (ESR) was carried out using the Westergreen method. There was a reduction in haematocrit, Hb and total leucocyte levels, though not significant (P>0.05), while there was a significant increase (P

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

Combination Antiretroviral Therapy in Human Immunodeficiency Virus–Infected Pregnant Women

Combination Antiretroviral Therapy in Human Immunodeficiency Virus–Infected Pregnant Women

Codon 215 Mutations in Human Immunodeficiency Virus–Infected Pregnant Women

In 1994, the Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 demonstrated a two-thirds reduction of perinatal human immunodeficiency virus (HIV) type 1 transmission with zidovudine chemoprophylaxis. However, zidovudine alone does not fully suppress HIV replication, and chemoprophylaxis with zidovudine alone might select for zidovudine-resistant viral variants, decreasing the efficacy of zidovudine prophylaxis and affecting future responses to combined antiretroviral regimens. Sixty-two HIV-infected pregnant women consecutively enrolled in the ongoing Swiss HIV and Pregnancy Study were prospectively evaluated for the presence or development of zidovudine resistance by analysis of codon 215 of the reverse transcriptase gene. Six women (9.6%) harbored a codon T215Y/F mutation, which is associated with high-level resistance to zidovudine. Postnatal evaluation was completed in all children of mothers harboring the mutation. None was HIV-infected. The observed prevalence of codon 215 mutations of 9.6% raises important concerns regarding the future use of the PACTG 076 regimen.