Risk Of Vertical Transmission Research Articles

Employing digital PCR for enhanced detection of perinatal Toxoplasma gondii infection: A cross-sectional surveillance and maternal-infant outcomes study in El Salvador.

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the risk of vertical toxoplasmosis transmission in the Western Region of El Salvador. Of 198 enrolled mothers at the time of childbirth, 6.6% had evidence of recent T. gondii infection-85% of these cases were identified using digital PCR. Neonates born to these acutely infected mothers were significantly more likely to meconium aspiration syndrome and mothers were more likely to experience labor and delivery complications. Multivariable logistic regression found higher maternal T. gondii infection odds were associated with the presence of pet cats, the definitive T. gondii host. In closing, this study provides evidence of maternal T. gondii infection, vertical transmission and deleterious fetal outcomes in a vulnerable population near the El Salvador-Guatemala border. Further, this is the first published study to show clinical utility potential of digital PCR for accurate diagnosis of congenital toxoplasmosis cases.

Parvovirus B19 in Pregnancy.

Although the risk of parvovirus B19 infection during pregnancy and subsequent risk of adverse fetal outcome are low, understanding management practices is essential for proper treatment of fetuses with nonimmune hydrops fetalis. In addition, continued investigation into delivery management, breastfeeding recommendations, and congenital abnormalities associated with pregnancies complicated by parvovirus B19 infection is needed. This review describes the risks associated with parvovirus B19 infection during pregnancy and the management strategies for fetuses with vertically transmitted infections. Original articles were obtained from literature search in PubMed, Medline, and OVID; pertinent articles were reviewed. Parvovirus B19 is a viral infection associated with negative pregnancy outcomes. Up to 50% of people of reproductive age are susceptible to the virus. The incidence of B19 in pregnancy is between 0.61% and 1.24%, and, overall, there is 30% risk of vertical transmission when infection is acquired during pregnancy. Although most pregnancies progress without negative outcomes, viral infection of the fetus may result in severe anemia, congestive heart failure, and hydrops fetalis. In addition, vertical transmission carries a 5% to 10% chance of fetal loss. In pregnancies affected by fetal B19 infection, Doppler examination of the middle cerebral artery peak systolic velocity should be initiated to surveil for fetal anemia. In the case of severe fetal anemia, standard fetal therapy involves an intrauterine transfusion of red blood cells with the goal of raising hematocrit levels to approximately 40% to 50% of total blood volume. One transfusion is usually sufficient, although continued surveillance may indicate the need for subsequent transfusions. There are fewer epidemiologic data concerning neonatal risks of congenital parvovirus, although case reports have shown that fetuses with severe anemia in utero may have persistent anemia, thrombocytopenia, and edema in the neonatal period. Parvovirus B19 is a common virus; seropositivity in the geriatric population reportedly reaches 85%. Within the pregnant population, up to 50% of patients have not previously been exposed to the virus and consequently lack protective immunity. Concern for parvovirus B19 infection in pregnancy largely surrounds the consequences of vertical transmission of the virus to the fetus. Should vertical transmission occur, the overall risk of fetal loss is between 5% and 10%. Thus, understanding the incidence, risks, and management strategies of pregnancies complicated by parvovirus B19 is essential to optimizing care and outcomes. Further, there is currently a gap in evidence regarding delivery management, breastfeeding recommendations, and the risks of congenital abnormalities in pregnancies complicated by parvovirus B19. Additional investigations into optimal delivery management, feeding plans, and recommended neonatal surveillance are needed in this cohort of patients.

Awareness of Pregnant Patients about Congenital Cytomegalovirus Infection-A Semi-Systematic Review.

Background: Cytomegalovirus (CMV) infection represents a major issue worldwide, since it constitutes the most common viral congenital infection, with a prevalence of 0.58% and 1-5% in developed and developing countries, respectively. According to recent studies, prenatal treatment significantly decreases the risk of vertical CMV transmission, and early intervention may even prevent the termination of pregnancy. This study aimed to investigate the level of awareness of CMV among pregnant patients through a semi-systematic review. Methods: We included all of the original articles investigating knowledge and awareness about CMV infection among pregnant women. Our research included the PubMed database. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, the Covidence system automatically guided us to screen the titles and/or abstracts, and then full-texts, followed by data extraction from the eligible studies. Results: We screened 764 studies altogether, with 13 studies included in this analysis. Knowledge about the existence of CMV infection risk varied between the articles, ranging from 11.4% in a study performed in Ireland to 60% reported in a study on the French population. Studies analyzing the impact of educational interventions on patients' knowledge about preventive measures reported significant improvement compared to their level of awareness before the intervention. Conclusions: Patients' awareness and knowledge about CMV seemed to be generally low or very low during the last decade before the development of effective secondary prevention methods. Educational interventions seem to be effective, and therefore their wide use could be of potential benefit. In the era of available secondary prevention of vertical transmission, it is crucial to concentrate the efforts of different stakeholders to increase the awareness of cCMV among pregnant women.

Family Planning Counseling for Women Living with HIV in Low- and Middle-Income Countries: A Systematic Review of the Impact on Contraceptive Uptake, Intention to Use Contraception and Pregnancy Incidence, 2011 to 2022.

Women's ability to control their fertility and have the number of children they want when they want them is an internationally recognized human right. This right has been the driving force behind family planning programs in low- and middle-income countries for more than five decades. The HIV epidemic added greater urgency to those efforts once the risk of vertical transmission of the virus from mothers to their infants was recognized. In 2013, we published a systematic review of the evidence of effectiveness of family planning counseling for women living with HIV, emphasizing HIV related behaviors. In this updated review, we examined 23 studies, primarily from sub-Saharan Africa. The evidence we uncovered reflected efforts to integrate services provided to women. These showed that providing contraceptive services, including intensified counseling and support, in the HIV clinics where women living with HIV received their care increased the likelihood of subsequent use of modern contraception by as much as fourfold. These studies reflected a greater focus on women's family planning decisions and behaviors and less focus on HIV-related behaviors. Among the possible causes of this noted difference we include the widespread coverage of antiretroviral treatment for HIV. This advance has apparently changed the rationale and the approach to integrating family planning and HIV services in ways that may not have been fully appreciated. The results, however, are beneficial: greater coverage of family planning for women who wish to control their fertility and a more equal partnership between family planning services and HIV services in pursuit of the mutual goal of providing integrated services to meet women's needs.

Navigating Perinatal Challenges: A Comprehensive Review of Hepatitis B Viral Infection and Pregnancy Outcomes.

Hepatitis B viral infection poses a significant challenge during pregnancy, as the risk of vertical transmission carries serious consequences for both maternal and neonatal well-being. This comprehensive review delves into the intricacies surrounding hepatitis B infection during the perinatal period, shedding light on its impact on pregnancy outcomes and stressing the necessity of addressing it within the broader framework of perinatal care. By scrutinizing current evidence, diagnostic methodologies, management techniques, and preventive measures, this review emphasizes the urgent need for enhanced screening protocols, timely interventions, and augmented public health initiatives. Notably, key findings underscore the elevated likelihood of chronic hepatitis B virus (HBV) infection in infants and its enduring implications for the health of both mothers and newborns. The imperative call to action advocates for a multifaceted approach, engaging healthcare professionals, policymakers, and public health agencies to optimize strategies for management and prevention, thereby striving for improved outcomes for pregnant women and their infants affected by hepatitis B viralinfection.

Epidemiology of acute hepatitis C and hepatitis C virus-related cirrhosis in reproductive-age women, 1990-2019: An analysis of the Global Burden of Disease study.

The current study uniquely focuses on the global incidence and temporal trends of acute hepatitis C (AHC) and hepatitis C virus (HCV)-related cirrhosis among women of reproductive age (15-49 years) from 1990-2019. The risk of vertical transmission and adverse perinatal outcomes associated with HCV infection underscores the importance of prioritising these women in HCV prevention efforts. Leveraging the Global Burden of Disease 2019 data, we calculated age-standardised incidence rates (ASIR) and assessed temporal trends via the average annual percent change from joinpoint regression. The age-period-cohort model was employed to understand further the effects of age, period, and birth cohort. Over the 30 years, global incidences of AHC and HCV-related cirrhosis in reproductive-age women increased by 46.45 and 72.74%, respectively. The ASIR of AHC was highest in low sociodemographic index regions but showed a declining trend. Conversely, the ASIR of HCV-related cirrhosis displayed unfavourable trends in low, low-middle, and high sociodemographic index regions. Special attention is necessary for sub-Saharan Africa, high-income North America, Eastern Europe, and Central Asia due to their high incidence rates or increasing trends of AHC and HCV-related cirrhosis. Notably, the age-period-cohort model suggests a recent resurgence in AHC and HCV-related cirrhosis risk. The current study is the first to thoroughly evaluate the trends of AHC and HCV-related cirrhosis among reproductive-age women, shedding light on previously unexplored aspects of HCV epidemiology. Our findings identify critical areas where health care systems must adapt to the changing dynamics of HCV infection. The detailed stratification by region and nation further enables the development of localised prevention and treatment strategies.

Prevalence of Maternal Chagas Disease and Vertical Transmission Rates in Bolivia: A Systematic Review and Meta-Analysis.

Bolivia has one of the highest burdens of Chagas disease in the world. Vertical transmission from mother to infant accounts for a growing number of cases. We performed a systematic review of articles assessing the prevalence of Chagas disease in pregnant women and rates of vertical transmission to infants in Bolivia. Studies were not excluded based on year of publication or language. Random-effects analyses were performed to estimate a pooled prevalence of maternal Chagas disease and pooled vertical transmission rate. Our search yielded 21 articles describing over 400,000 cases of Chagas disease among pregnant women in Bolivia. The reported prevalence of maternal Chagas disease ranged from 17.3% to 64.5%, with a pooled prevalence of 33.0% (95% CI, 27.4-38.7%). The prevalence of maternal Chagas disease trended down over time (P = 0.006), decreasing by approximately 25% to 30% over the last 40 years. Vertical transmission rates ranged from 2.0% to 13% with a pooled average of 6.2% (95% CI, 4.4-7.5%); rates did not significantly change over time. Our study is the first systematic review and meta-analysis of Chagas disease maternal prevalence and vertical transmission in Bolivia. Our findings indicate that maternal Chagas disease has fallen in prevalence but still affects 20% to 30% of pregnant women and poses a considerable risk of vertical transmission. Pregnant women and infants are an important target for public health interventions to limit the mortality and morbidity of Chagas disease and to reduce intergenerational spread.

Epidemiological and Clinical Characteristics of Neonatal Ureaplasma urealyticum Infection.

To understand the epidemiology and clinical features of Ureaplasma urealyticum (UU) infection in hospitalized neonates due to vertical transmission from mother to child. Respiratory secretions were collected from neonates hospitalized in the neonatology department of the Maternal and Child Health Hospital of Hubei Province from July 2020 to June 2022, and PCR was used to detect UU-DNA in respiratory secretions. The neonates were divided into UU-positive and UU-negative groups, the epidemiological and clinical characteristics of two groups, were statistically analyzed. A total of 7257 hospitalized neonates were included in this study, of whom 561 were UU positive and 6696 were UU negative, with a UU detection rate of 7.73%. The detection rate among female neonates was higher than male neonates, and the highest detection rate was found in the period from 1-7 days after birth; the detection rate was highest in spring and fall, and the lowest in winter, but the overall difference was not statistically significant (P>0.05). Compared with the UU-negative group, neonates in the UU-positive group were more likely to be preterm, have a lower birth weight, be delivered vaginally, and have maternal preterm rupture of membranes. In addition, neonates in the UU-positive group were more likely to be co-infected with pathogens and to have complications related to UU infections, which were all statistically significant (P<0.05). Neonatal UU infections are detected more frequently in female infants, with the highest detection rate occurring in 1-7 days after birth, and the most prevalent periods for infection being spring and fall. Vaginal delivery and premature rupture of membranes may lead to an increased risk of vertical UU transmission from mother to child, and UU infection is strongly associated with preterm labor, low birth weight, pathogen co-infection, and related complications.

Prevalence of Hepatitis B and C Infection and its Associated Risk factors in Pregnant Women Visiting Hospitals of Southern Punjab

Background: Hepatitis B and C infections remain formidable challenges to global health, with significant morbidity and mortality rates, especially among pregnant women. These infections pose substantial risks not only to the infected individuals but also to their unborn children, due to the potential for vertical transmission. In Pakistan, particularly in the Southern Punjab region, the prevalence and impact of these infections demand rigorous investigation to inform public health strategies. Objective: This study aimed to assess the prevalence of Hepatitis B and C infections among pregnant women visiting selected hospitals in Southern Punjab, Pakistan, and to identify associated risk factors, thereby contributing to the formulation of targeted intervention strategies. Methods: Employing an analytical cross-sectional design, this study involved 422 pregnant women from the outpatient departments of Gynecology at Nishtar Hospital, Shahbaz Sharif Hospital in Multan, and Bismillah Medical Complex in Kahror Pacca, between December 1, 2023, and March 5, 2024. Participants were selected using a convenience sampling technique. Data on demographic characteristics and potential risk factors were collected through a structured questionnaire. Hepatitis B and C seropositivity was determined through specific serological tests. The analysis was performed using SPSS version 25, focusing on the prevalence rates and the identification of major and minor risk factors for the transmission of Hepatitis B and C. Results: The study found an 8.3% prevalence rate for Anti-HCV and a 5.2% prevalence rate for HBsAg among the participants. Notable risk factors included ear or nose piercings, history of blood transfusions, and previous cesarean sections. Socio-demographic analysis revealed higher rates of infection among participants with lower educational levels, those residing in rural areas, and among certain age groups and parity statuses. Conclusion: The observed prevalence rates of Hepatitis B and C infections among pregnant women in Southern Punjab highlight the critical need for enhanced screening programs, targeted vaccination initiatives, and comprehensive education campaigns to mitigate the risk of vertical transmission and reduce the burden of these infections.

Birth Outcomes and Retention in Care among HIV-Exposed Infants at a Tertiary Care Hospital in Thailand

Objective: To describe birth outcomes and retention in care at 6 and 18 months after birth and identify associated factors among pregnant women living with HIV and their infants. Materials and Methods: A retrospective descriptive study was conducted at a large tertiary care center in Bangkok, Thailand. Retention in care among postpartum women living with HIV was defined as the follow-up duration after delivery at an HIV clinic. High risk of HIV vertical transmission was defined according to a standard guideline. Results: Between January 2015 and December 2019, 153 pregnant women living with HIV with 154 live births of HIV-exposed infants were reviewed and categorized into 132 (86%) low risk and 21 (14%) high risk groups. The overall median maternal age was 31 years (IQR 26 to 35). High-risk mothers were younger at a median age of 25 years versus 32 years (p=0.009). Nineteen (12%) of the mothers experienced premature labor and 31 (20%) of the infants had low birth weight. Early infant diagnosis was completed among 143 (93%) of the HIV-exposed infants, with one child infected with HIV. Overall HIV transmission rate was 0.6% (95% CI 0.1 to 3.5). Pregnant women with detectable HIV RNA before delivery had a higher risk of low-birth-weight infants (aOR 3.19, 95% CI 1.12 to 9.04). Retention in care of postpartum women was 85.0% (95% CI 78.3 to 89.7) and 76.5% (95% CI 68.9 to 82.4), at 6 and 18 months after delivery, respectively. Mothers who initiated antiretroviral therapy (ART) before pregnancy had a higher probability ofretention in care at 85.5% (95% CI 76.0 to 91.5) compared to mothers who initiated ARV during pregnancy or after delivery at 65.7% (95% CI 53.3 to 75.5, p=0.012). Conclusion: High-risk HIV-exposed infants were at higher risk of loss in retention of care. Developing an effective program for this target population is needed. Keywords: Birth outcomes; HIV; HIV-exposed infant; Retention

Investigating vertical transmission and maternofoetal outcomes in pregnant women with COVID-19: a case-control study from Pakistan.

To estimate the frequency of severe acute respiratory syndrome coronavirus-2 among pregnant women, the impact in terms of obstetrical and clinical outcomes and vertical transmission to the neonates. The prospective, case-control study was conducted at Zainab Panjwani Memorial Hospital, Karachi, from March to December 2021, and comprised pregnant women regardless of gestational age who exhibited symptoms or had a suspicion of exposure to any confirmed coronavirus disease-2019 individual. They were screened for severe acute respiratory syndrome coronavirus-2 infection using polymerase chain reaction or serology. Those who tested negative were designated as control group A, while who had a positive serology result along with a negative polymerase chain reaction were taken as recovered case group B1, and those who tested positive for polymerase chain reaction were called the positive case group B2. Groups B1 and B2 were followed up till delivery. The clinical presentation of coronavirus disease-2019 infection in pregnancy and its obstetrical and neonatal outcomes was assessed. Products of conception were tested for the detection of the severe acute respiratory syndrome coronavirus-2 genome. The viral genome from group B2 cases was sequenced to confirm vertical transmission. Data was analysed using GraphPad Prism V8. Of the 139 pregnant women, 74(53.2%) were in group A with mean age 25.87±6.90 years, 49(35.3%) were in group B1 with mean age 25.53±7.02 years, and 16(11.5%) were in group B2 with mean age 27.12±5.03 years. The gestational age at which termination of pregnancy occurred was 38.3±1.26 weeks in group B1 and 38.3±1.85 weeks for group B2. There were 96 neonates across the 3 groups. Of the 11(11.45%) neonates in group B2, 1(9.09%) had postnatal transmission of severe acute respiratory syndrome coronavirus-2 and this mother-neonate case was taken as the Indexed case. The severe acute respiratory syndrome coronavirus-2 genome isolated from the neonate showed similar mutations as the viral strain infecting the mother. The risk of vertical transmission was found to be low. The severe acute respiratory syndrome coronavirus-2 genome was the same for both the mother and the neonate.

Eosinophil Count Fluctuations during Pregnancy in Women with HIV: A Comprehensive Review

Pregnancy in women with Human Immunodeficiency Virus (HIV) presents a unique set of challenges, necessitating a closer examination of the immune system’s responses, particularly in relation to eosinophil dynamics. This comprehensive review explores the fluctuations in eosinophil counts during pregnancy in HIV-positive women, emphasizing the intricate interplay between the immune system, maternal health, and the risk of vertical transmission. The impact of Antiretroviral Therapy (ART) on eosinophil regulation is also investigated, offering valuable insights into potential therapeutic strategies. By unraveling the complexities of eosinophil dynamics in this specific population, this review aims to contribute to a deeper understanding of maternal immune adaptations and pave the way for targeted interventions to optimize health outcomes for both mothers and infants.

The Impact of HIV Infection on Eosinophil Levels during Pregnancy: A Narrative Review

Human Immunodeficiency Virus (HIV) infection poses unique challenges during pregnancy, affecting maternal health and potentially impacting the developing fetus. This systematic review explores the intricate relationship between HIV and eosinophils, a critical component of the immune system, during pregnancy. As HIV induces immunosuppression, understanding its specific effects on eosinophil levels is crucial for predicting maternal health outcomes and vertical transmission risks. The review also delves into the potential influence of antiretroviral therapy on modulating eosinophil function. By synthesizing existing literature, this review aims to provide a comprehensive understanding of the complex interplay between HIV infection, eosinophils, and pregnancy, offering insights for future research directions and potential therapeutic interventions.

Human papillomavirus infection (HPV) and pregnancy.

Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.

Percepciones y sentimientos de mujeres embarazadas con toxoplasmosis en seguimiento ambulatorio

Introduction: Toxoplasmosis persists as a neglected disease and poses a challenge to public health, especially due to the risk of vertical transmission, which can lead to countless biological complications for the newborn and to psychological and emotional repercussions for the mother. Objective: To understand the perceptions and feelings of pregnant women affected by toxoplasmosis undergoing outpatient follow-up. Materials and Methods: A qualitative and exploratory study developed with 12 women with gestational toxoplasmosis undergoing specialized outpatient follow-up in a municipality from the state of Paraná, Brazil. The data were collected through semi-structured individual interviews and subjected to content analysis, supported by descending hierarchical classification. Results: The pregnant women experienced situations ranging from diagnosis and treatment to preventing the disease in the child and family. These experiences generated fear, distress and uncertainty about the disease, which were not adequately addressed during prenatal assistance in primary care. However, the pregnant women emphasized the importance of the multiprofessional team at the secondary level in monitoring and health education. Discussion: Although the pregnant women felt confident about the treatment and its implications for the child's health, discovering the diagnosis impacted their everyday lives and those of their families, especially due to lack of reliable information about toxoplasmosis and to the absence of emotional support at the primary level. Conclusions: There was a temporary scenario of disinformation among these women, who were not properly guided and supported. However, the guidelines offered in secondary health care were essential for improving knowledge and practices in health.

"It Soothes Your Heart": A Multimethod Study Exploring Acceptability of Point-of-Care Viral Load Testing among Ugandan Pregnant and Postpartum Women Living with HIV.

High adherence to antiretroviral therapy (ART) is critical for achieving viral suppression and preventing onward HIV transmission. ART continuation can be challenging for pregnant women living with HIV (PWLHIV), which has critical implications for risk of vertical HIV transmission. Point-of-care viral load (POC VL) testing has been associated with improved treatment and retention outcomes. We sought to explore acceptability of POC VL testing among Ugandan PWLHIV during pregnancy and postpartum. This multimethod analysis drew on quantitative and qualitative data collected between February and December 2021. Quantitatively, we used an intent-to-treat analysis to assess whether randomization to clinic-based POC VL testing during pregnancy and infant testing at delivery was associated with improved viral suppression (≤50 copies/mL) by 3 months postpartum compared to standard-of-care (SOC) VL testing through a central laboratory, adjusting for factorial randomization for the male partner testing strategy. Additionally, a subset of 22 PWLHIV in the POC VL arm participated in in-depth qualitative interviews. We inductively analyzed transcripts to develop categories representing concepts that characterized women's perceptions of POC VL testing during pregnancy and at delivery and ways that POC VL testing may have impacted their ART adherence and viral suppression. Key themes around women's perceptions of POC VL testing were then organized into main categories. Overall, 151 PWLHIV were enrolled into the study, 77 (51%) of whom were randomized to receive POC VL testing during pregnancy and at delivery. Women reported in qualitative interviews that POC VL testing had (1) motivated their ART adherence during pregnancy and postpartum and that they felt this testing method had (2) helped them protect their infants from acquiring HIV and (3) improved their emotional wellbeing. POC VL testing was highly acceptable among Ugandan PWLHIV and was viewed as an important tool that women believed improved their ART adherence, gave them information necessary to protect their infants from vertical HIV acquisition, and improved their emotional wellbeing. These findings support the global scale-up of POC VL testing in settings with high HIV burden, especially for PWLHIV who may be at risk of treatment disruptions or loss to follow-up.

Impact of Protease Inhibitor-Based Highly Active Antiretroviral Therapy on Fetal Subcutaneous Fat Tissue in HIV-Pregnant Women in a Middle-Income Country.

HIV infection continues to be a global public health challenge, affecting approximately 1.7 million reproductive-aged women. Protease inhibitor-based highly active antiretroviral therapy (PI-HAART) has significantly reduced the risk of vertical transmission of HIV from mother to child. Nevertheless, concerns linger regarding the long-term effects, particularly on body composition, notably subcutaneous fat tissue (SFT). Although HIV-associated lipodystrophy syndrome (LS) has been well documented in adults and older children, its impact on fetuses exposed to PI-HAART remains underexplored. This study aims to evaluate SFT in the fetuses of HIV-pregnant women exposed to PI-HAART, assessing the potential clinical implications. We conducted a comparative study between HIV-pregnant women receiving PI-HAART and an HIV-negative control group. Fetometry measurements were obtained via 3D ultrasound. SFT in the fetal arm and thigh segments was assessed. Data were analyzed using lineal multivariate regression and receiver-operating characteristics (ROC)-curve analysis. Fetuses exposed to PI-HAART exhibited a significant reduction in subcutaneous fat, particularly in the proximal third-middle union of the femur (coefficient: -2.588, p = 0.042). This reduction was correlated with lower newborn serum glucose levels (65.7 vs. 56.1, p = 0.007; coefficient: -1.277, p = 0.045). Our study sheds light on the connection between PI-HAART, fetal subcutaneous fat, and neonatal health. These findings might reveal the long-lasting effects of PI-HAART on newborns and children's well-being. Our results emphasize the need for a more balanced approach to managing pregnant women with HIV in developing countries and open new venues for research on the impact of intrauterine PI-HAART exposure on energy metabolism and fetal programming.

Hubungan Pemeriksaan Triple Eliminasi terhadap Pencegahan Penyakit Menular Seksual pada Ibu Hamil

The risk of vertical transmission of HIV/AIDS, Hepatitis B, and Syphilis from mother to child is significant. The likelihood of HIV/AIDS being transmitted vertically from mother to kid varies between 20% and 45%, for syphilis it ranges from 69% to 80%, and for Hepatitis B it surpasses 90%. Every expectant mother has triple screening for HIV, Syphilis, and Hepatitis B to reduce the risk of transmission to the newborn. As to the Ministry of Health of the Republic of Indonesia (2019), it is obligatory for pregnant women to undergo triple elimination screening to mitigate the transmission of HIV/AIDS, Syphilis, and Hepatitis B. The research aimed to evaluate the effectiveness of the Triple Elimination Examination in preventing the spread of sexually transmitted illnesses among pregnant women in Mojongapit Village, Jombang.&#x0D; This study is a retrospective cohort investigation that specifically examines mothers who had their babies in Mojongapit Village. Carry out study from June to August 2023. The study's independent variable is the triple elimination examination, whereas the dependent variable is the incidence of diseases transmitted from mother to newborn. A purposeful selection method was used to choose twenty-eight mothers who had previously given birth, and their history of triple elimination examination was observed. Performing analysis using the Spearman rank correlation approach.&#x0D; The research revealed that 96.2% of the 25 mothers who were not infected with sexually transmitted illnesses had triple elimination examinations in the first trimester. The Spearman Rank statistical test resulted in a p value of 0.000, demonstrating a strong correlation between the occurrence of sexually transmitted infections and the implementation of triple elimination examinations in Mojongapit Village, Jombang.&#x0D; The implementation of the triple elimination initiative, which includes screening, treatment, and is characterized by its cost-effectiveness and efficiency, has shown its effectiveness in avoiding the transmission of HIV, syphilis, and hepatitis B from mother to child.

The potential benefits of long-acting injectable cabotegravir in pregnant and breastfeeding women and their infants.

Pregnant and breastfeeding women (PBW) in sub-Saharan Africa have high HIV incidence rates and associated risk of vertical transmission to their infants. Oral preexposure prophylaxis (PrEP) and injectable PrEP (long-acting cabotegravir, or CAB-LA) can potentially reduce this HIV transmission, but population-level impacts are uncertain. We extended a previously developed model of HIV and PrEP in South Africa to allow for variable PrEP duration and preference in PBW. We considered three potential scenarios for PrEP provision to PBW: oral PrEP only, CAB-LA only, and allowing oral/CAB-LA choice, with uptake and retention assumptions informed by South African data, each compared with a 'base' scenario without PrEP for PBW. Without PrEP for PBW, the model estimates 1.31 million new infections will occur between 2025 and 2035 in South African adults and children, including 100 000 in PBW, 16 800 in infants at/before birth, and 35 200 in children through breastmilk. In the oral PrEP-only scenario, these numbers would reduce by 1.2% (95% CI: 0.7-1.7%), 8.6% (4.8-12.9%), 4.0% (2.1-5.8%), and 5.3% (3.0-8.2%) respectively. In the CAB-LA-only scenario, the corresponding reductions would be 6.1% (2.9-9.6%), 41.2% (19.8-65.0%), 12.6% (6.0-19.4%), and 29.5% (13.9-46.8%), respectively, and in the oral/CAB-LA choice scenario, similar reductions would be achieved [5.6% (3.4-8.0%), 39% (23.4-55.9%), 12.4% (7.4-16.8%) and 27.6% (16.5-39.9%) respectively]. CAB-LA has the potential to be substantially more effective than oral PrEP in preventing HIV acquisition in PBW and vertical transmission, and can also modestly reduce HIV incidence at a population level.

Comparative assessment of veneral disease research laboratory (VDRL) and point of care (POC) tests for diagnosing syphilis among pregnant women at a tertiary health facility in Lagos: A retrospective cohort study

Background: Syphilis is a systemic infection caused by the Spirochete Treponema Pallidum. The infection is of particular concern during pregnancy because of the high risk of vertical transmission causing adverse outcome including death. Traditional screening method is with Venereal Disease Research Laboratory (VDRL), which has a high false positive result and an increased waiting time. Aim: To compare the syphilis detection rate between Point-of-Care testing and Venereal Disease Research Laboratory testing among pregnant women. Methods: The retrospective cohort study was conducted at 68 Nigerian Army Reference Hospital Yaba (68NARHY), Lagos between July 2021 and June 2023. Data from antenatal clinic records were retrieved. All eligible pregnant women had both POC and VDRL testing. The primary outcome measures were false positive, false negative, true positive, true negative of the two tests. The sensitivity, and specificity and the diagnostic accuracy of both tests were calculated following which the ROC curve was drawn. Women with incomplete record or who did not conduct both testing were excluded from the study. All data set were collected using a well-designed purpose driven proforma. The data set were stored and later analyzed using the IBM SPSS for Windows, version 26.0 Armonk, NY: IBM corp. Analysis was both descriptive and inferential. The p-value of &lt; 0.05 was set as statistically significant levels. Result: The mean age of the participants was 31.30±5.3. About 45.5% were of low parity while military personnel consisted of more than half of the study population. The prevalence of syphilis was 1.8% and 4.3% using VDRL and POC test kits respectively. When compared, there was a significant difference (P&lt;0.001). It was also noted that a greater proportion of military personnel were reactive to the screening using either of those kits as against civilians. Conclusion: In our study, POC has demonstrated its ability to detect more cases of syphilis than VDRL as a screening test. Therefore, POC may serve as a cost-effective replacement screening test for VDRL, to rapidly and accurately detect syphilis infection. This step is crucial for early diagnosis, prompt treatment, and the prevention of further transmission of syphilis.