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Mother-to-child Transmission (mother-to-child + transmission)

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Medical Sciences	75%

Selected Abstracts

Vitamin A, Mastitis, and Mother-to-Child Transmission of HIV-1 through Breast-feeding: Current Information and Gaps in Knowledge

NUTRITION REVIEWS, Issue 10 2005
Stephanie M. Dorosko DVM
Mastitis has been implicated as a risk factor for mother-to-child transmission (MTCT) of HIV-1 through breast-feeding. Maternal vitamin A deficiency is also associated with increased MTCT, as well as with episodes of mastitis in lactating animals. This review describes the complex interrelationship between vitamin A, mastitis, and MTCT of HIV-1 via mothers' milk. Current gaps in knowledge, as well as recommendations for future research efforts, are also discussed. [source]

Mother-to-Child Transmission of HIV in China and the USA: A Comparative Analysis

ASIAN SOCIAL WORK AND POLICY REVIEW, Issue 3 2010
Susanna Arcella
This paper analyzes and compares the existing policies and programs for the prevention of mother-to-child transmission of HIV existing in China and in the USA. The implementation of these is still imperfect and there needs to be improvements in the education (the spreading of information) and in the general health care system of China. Particular attention will be drawn to the existing barriers to the effective implementation of prevention of mother-to-child-transmission. The recommendations aim to solve similar barriers in both countries and some specifically dealing with problems in China. Since HIV infection in children is caused almost entirely by prenatal transmission, it is important that the governments, in partnership with civic society organizations, make all the necessary efforts to save the lives of their newborn citizens. [source]

Factors determining HIV viral testing of infants in the context of mother-to-child transmission

ACTA PAEDIATRICA, Issue 4 2010
K Peltzer
Abstract Aim:, The aim of this study was to investigate factors determining HIV viral testing of infants in the context of Prevention of Mother-to-Child Transmission of HIV (PMTCT). Methods:, Post-delivery HIV infected mothers 18 years and above with babies aged 3,6 months were interviewed on HIV viral testing of infants and factors associated with it. Results:, Among 311 HIV infected women 61.7% had their infant tested for HIV between 4 and 8 weeks. Bivariate analyses found that older age of the mothers, lower depression scores, higher PMTCT knowledge, low PMTCT risk behaviour (maternal and infant nevirapine adherence, health facility delivery and exclusive formula feeding), HIV status disclosure and attending a support group were associated with PCR test participation. In multivariate analyses higher PMTCT knowledge, infant nevirapine adherence, and not exclusive breast feeding were associated with polymerase chain reaction test participation. Conclusion:, Various determinants of acceptance of participation in HIV viral testing of infants in the context of PMTCT were identified that can guide infant testing and diagnosis counselling and support services of PMTCT programmes. [source]

Mother-to-Child Transmission of HIV-1

ACTA PAEDIATRICA, Issue 11 2001
August 2001., Italy, Meeting of World Federation of Scientists in Erice
No abstract is available for this article. [source]

REVIEW: Preventing mother-to-child transmission of HIV: successes and challenges

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2005
James McIntyre
Mother-to-child transmission of HIV continues to be a major cause of infant morbidity and mortality in resource-poor settings. Intrapartum and postpartum nevirapine-based regimens have been introduced in many settings. New research has shown that better efficacy can be achieved with the addition of single-dose nevirapine to short course zidovudine regimens, and that selection of nevirapine-resistant virus can be reduced with a short postpartum combination antiretroviral cover. Women who need antiretroviral therapy for their own health should receive it in pregnancy, and access for pregnant women needs to be expanded urgently. The reduction of transmission through breastfeeding remains a challenge. [source]

Intrafamilial Transmission of Helicobacter pylori among the Population of Endemic Areas in Japan

HELICOBACTER, Issue 2 2007
Yayoi Fujimoto
Abstract Background:,Helicobacter pylori (H. pylori) infection is a worldwide phenomenon related to several gastrointestinal diseases. However, because many aspects concerning the route of transmission remain unclear, we performed this epidemiologic study to clarify the route of intrafamilial transmission of H. pylori. Materials and Methods:, A retrospective study was performed in three widely separate areas in Japan to investigate the prevalence of H. pylori infection. In 1993, 613 residents were tested as were 4136 in 2002, including 1447 family members of 625 families. Antibody to H. pylori (anti- H. pylori) was determined by enzyme-linked immunosorbent assay. Results:, In 2002, the age-adjusted anti- H. pylori prevalence in Hoshino Village (67.5%) was significantly higher than in Kasuya Town (55.0%) and in Ishigaki City (54.7%) (p < .0001, p = .0039, respectively). The age-adjusted anti- H. pylori prevalence of Ishigaki City significantly decreased from 1993 (68.4%) to 2002 (52.5%), showing an age cohort effect. However, the prevalence did not significantly differ in children aged 0,6 years of Ishigaki City between 1993 (9.6%) and 2002 (10.3%). A familial analysis in 2002 demonstrated that the prevalence of anti- H. pylori was significantly higher in children with anti- H. pylori -positive (21.6%, 22 of 102) than with -negative mothers (3.2%, 3 of 95) (p < .0001, by Mantel,Haenszel test), whereas there was no significant difference between children with anti- H. pylori -positive and -negative fathers. Moreover, the prevalence was significantly higher in wives with anti- H. pylori -positive (64.0%, 208 of 325) than with -negative husbands (46.5%, 80 of 172) (p = .0071, by Mantel,Haenszel test) and in husbands with anti- H. pylori -positive (72.2%, 208 of 288) than with -negative wives (56.0%, 117 of 209) (p = .0106, by Mantel,Haenszel test). Conclusions:, In the last decade, H. pylori infection decreased in the general population of Japan by improvement of general hygiene conditions, but did not differ in young children, most likely because of mother-to-child transmission. [source]

Tenofovir disoproxil fumarate in pregnancy and prevention of mother-to-child transmission of HIV-1: is it time to move on from zidovudine?

HIV MEDICINE, Issue 7 2009
C Foster
Objectives Zidovudine (ZDV) has been the cornerstone of antiretroviral (ARV) therapy for pregnant women infected with HIV-1 in the prevention of mother-to-child transmission (MTCT) and remains the only licensed ARV for use in pregnancy. We explored the current and future roles of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT of HIV-1. Methods We reviewed the published literature by conducting database searches of in vitro, animal and clinical studies, reported in journals and at conferences, using the search terms Tenofovir/gs4331/viread, pregnant/pregnancy, lactate, lactation, natal, reproduce/reproduction, placenta/placental, malformation, and teratogenicity/teratogenic. Results In a macaque model, perinatal exposure to very high dose tenofovir resulted in bone toxicity in some offspring. However, perinatal use of TDF, both single dose and as part of highly active antiretroviral therapy in women, has been well tolerated in the short term by mothers and their infants. Further, the addition of single-dose TDF to single-dose nevirapine (SD-NVP) during delivery following maternal ZDV use during pregnancy significantly reduces the frequency of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance. Conclusions The addition of TDF to SD-NVP reduces NNRTI resistance. The role of TDF in this setting and during pregnancy for reducing rates of MTCT requires investigation. While short-term toxicity data are encouraging, long-term follow-up of exposed mothers and infants is required. [source]

Non-nucleoside reverse transcriptase inhibitors: a review

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2007
L. Waters
Summary Non-nucleoside reverse transcriptase inhibitors form the backbone of antiretroviral treatment for many HIV-infected individuals. The tolerability, pill burden and efficacy associated with this class of agents make them a frequent choice for first-line therapy. Here we review nevirapine and efavirenz in terms of efficacy, resistance and toxicity, focusing particularly on the use of nevirapine to prevent mother-to-child transmission in developing countries. [source]

A systematic review of counselling for HIV testing of pregnant women

JOURNAL OF CLINICAL NURSING, Issue 13 2009
Karin S Minnie
Background., Evidence-based strategies have made it possible to limit mother-to-child transmission of the HI-virus to a large extent and enable HIV-positive women to stay healthy for longer, provided their HIV status is known. Although voluntary counselling and testing for HIV is part of routine antenatal care in South Africa, the uptake of testing varies and a large number of pregnant women's HIV status is not known at the time of birth. Aim., The aim of the study was to establish research evidence regarding factors influencing counselling for HIV testing during pregnancy by means of systematic review, forming part of a larger study using a variety of evidence to develop best practice guidelines. Design., Systematic review. Methods., The question steering the review was: ,What factors influence counselling for HIV testing during pregnancy?'. A multi-stage search of relevant research studies was undertaken using a variety of sources. A total of 33 studies were retrieved and critically appraised. Data were extracted from the studies and assessed according to its applicability in the South African context. Results., The results are presented according to the following themes: effects of counselling, quality of counselling, group vs. individual counselling, ways of offering HIV testing, rapid testing, counselling and testing during labour, couple counselling and testing, counsellor and organisational factors. Conclusions., According to research evidence, factors such as whether counselling is presented in a group or individually, different ways to present HIV testing as well as counsellor and organisational factors can influence counselling for HIV testing during pregnancy. When developing best practice guidelines for settings very dissimilar from where the research was done, research evidence must be contextualised. Relevance to clinical practice., Implementation of the best practice guidelines may lead to the increased uptake of HIV testing in pregnancy in developing countries like South Africa and thus to an increase in the number of women whose status is known when their babies are born. [source]

Systematic review of the efficacy of antiretroviral therapies for reducing the risk of mother-to-child transmission of HIV infection

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 3 2007
N. Suksomboon PhD
Summary Objective:, To evaluate the efficacy of antiretroviral therapies in reducing the risk of mother-to-child transmission of HIV infection. Methods:, Systematic review and meta-analysis of randomized controlled trials. Clinical trials of antiretrovirals were identified through electronic searches (MEDLINE, EMBASE, BIOSIS, EBM review and the Cochrane Library) up until November 2006. Historical searches of reference lists of relevant randomized controlled trials, and systematic and narrative reviews were also undertaken. Studies were included if they were (i) randomized controlled trials of any antiretroviral therapy aimed at decreasing the risk of mother-to-child transmission of HIV infection, (ii) reporting outcomes in terms of HIV infection in infant, infant death, stillbirth, premature delivery, or low birth weight. The data were extracted by a single investigator and checked by a second investigator. Disagreements were resolved through discussion or a third investigator. The efficacy was estimated using relative risk (RR), risk difference (RD) and number needed to treat (NNT) together with 95% confidence intervals. Results:, Fifteen trials were included in the systematic review. Based on five placebo-controlled trials, a zidovudine regimen reduced the risk of mother-to-child transmission by 43% (95% CI: 29,55%). The incidence of low birth weight seems to be decreased with zidovudine (pooled RR 0·75, 95% CI: 0·57,0·99). The efficacy of short-short course of zidovudine was comparable with that of the long-short course. Nevirapine monotherapy given to mothers and babies as a single dose reduced the risk of vertical transmission compared with an intrapartum and post-partum regimen of zidovudine (RR 0·60, 95% CI: 0·41,0·87). Zidovudine plus lamivudine was effective in reducing the risk of maternal-child transmission of HIV (RR 0·63, 95% CI: 0·45,0·90). Adding zidovudine to single-dose nevirapine in babies was no more effective than nevirapine alone (pooled RR 0·88, 95% CI: 0·47,1·63), nor was there any significant difference between zidovudine plus lamivudine and nevirapine. In mothers who were treated with standard antiretroviral therapy, no additional benefit was observed with the addition of a single dose of nevirapine in mothers and newborns. In addition, for mothers who received zidovudine prophylaxis, a two-dose intrapartum/newborn nevirapine reduced the risk of HIV infection and death of babies by 68% (95% CI: 39,83%) and 80% (95% CI: 10,95%), respectively, when compared with placebo. Conclusions:, The available evidence suggests that zidovudine alone or in combination with lamivudine and nevirapine monotherapy is effective for the prevention of mother-to-child transmission of HIV. They may also be beneficial in reducing the risk of infant death. Different antiretroviral regimens appear to be comparably effective in reducing HIV transmission from mothers to babies. In mothers already receiving zidovudine prophylaxis, adding a single dose of nevirapine to mothers during labour and giving the same drug to infants may further decrease the risk of vertical transmission and infant death. [source]

LTR real-time PCR for HIV-1 DNA quantitation in blood cells for early diagnosis in infants born to seropositive mothers treated in HAART area (ANRS CO 01)

JOURNAL OF MEDICAL VIROLOGY, Issue 2 2009
Avettand-Fènoël Véronique
Abstract HIV-1 diagnosis in babies born to seropositive mothers is one of the challenges of HIV epidemics in children. A simple, rapid protocol was developed for quantifying HIV-1 DNA in whole blood samples and was used in the ANRS French pediatric cohort in conditions of prevention of mother-to-child transmission. A quantitative HIV-1 DNA protocol (LTR real-time PCR) requiring small blood volumes was developed. First, analytical reproducibility was evaluated on 172 samples. Results obtained on blood cell pellets and Ficoll-Hypaque separated mononuclear cells were compared in 48 adult HIV-1 samples. Second, the protocol was applied to HIV-1 diagnosis in infants in parallel with plasma HIV-RNA quantitation. This prospective study was performed in children born between May 2005 and April 2007 included in the ANRS cohort. The assay showed good reproducibility. The 95% detection cut-off value was 6 copies/PCR, that is, 40 copies/106 leukocytes. HIV-DNA levels in whole blood were highly correlated with those obtained after Ficoll-Hypaque separation (r,=,0.900, P,<,0.0001). A total of 3,002 specimens from 1,135 infants were tested. The specificity of HIV-DNA and HIV-RNA assays was 100%. HIV-1 infection was diagnosed in nine infants before age 60 days. HIV-DNA levels were low, underlining the need for sensitive assays when highly active antiretroviral therapy (HAART) has been given. The performances of this HIV-DNA assay showed that it is adapted to early diagnosis in children. The results were equivalent to those of HIV-RNA assay. HIV-DNA may be used even in masked primary infection in newborns whose mothers have received HAART. J. Med. Virol. 81:217,223, 2009. © 2008 Wiley-Liss, Inc. [source]

Zidovudine with nevirapine for the prevention of HIV mother-to-child transmission reduces nevirapine resistance in mothers from the Western Cape, South Africa

JOURNAL OF MEDICAL VIROLOGY, Issue 6 2008
G.U. van Zyl
Abstract In the Western Cape province of South Africa, an intensified regimen for the prevention-of-mother-to-child-transmission-of-HIV consisting of zidovudine (AZT) from 34 weeks of pregnancy plus single dose (sd) nevirapine (NVP) during labor was instituted in 2004. The newborn baby receives a single dose of NVP and AZT for 7 days. Similar strategies in Thailand and Africa have been shown to be more effective in reducing transmission than NVP alone. The use of sd NVP only for the prevention-of-mother-to-child-transmission-of-HIV has a high risk of inducing resistance (25,69%) with an average of 35.7% by a recent meta-analysis and has been shown to adversely affect non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy when initiated within 6 months. In this study the prevalence of resistance to NVP and AZT in mothers who had received the intensified regimen was measured. Specimens collected from mothers were genotyped by in-house PCR and sequencing. In specimens obtained within 60 days of delivery, acquired NVP resistance mutations were detected in 13 of 76 patients (17.1%, 95% confidence interval: 8.7,25.6%), which appears to be lower than in studies with sd NVP alone (37.5%, 95% confidence interval: 23.0,50.6%). J. Med. Virol. 80:942,946, 2008. © 2008 Wiley-Liss, Inc. [source]

Effective program against mother-to-child transmission of HIV at Saint Camille Medical Centre in Burkina Faso

JOURNAL OF MEDICAL VIROLOGY, Issue 7 2007
J. Simpore
Abstract The present research was aimed to prevent mother-to-child transmission of HIV; to use RT-PCR in order to detect, 6 months after birth, infected children; and to test the antiretroviral resistance of both children and mothers in order to offer them a suitable therapy. At the Saint Camille Medical Centre, 3,127 pregnant women (aged 15,44 years) accepted to be enrolled in the mother-to-child transmission prevention protocol that envisages: (i) Voluntary Counselling and Testing for all the pregnant women; (ii) Antiretroviral therapy for HIV positive pregnant women and for their newborns; (iii) either powdered milk feeding or short breast-feeding and RT-PCR test for their children; (iv) finally, pol gene sequencing and antiretroviral resistance identifications among HIV positive mothers and children. Among the patients, 227/3,127 HIV seropositive women were found: 221/227 HIV-1, 4/227 HIV-2, and 2/227 mixed HIV infections. The RT-PCR test allowed the detection of 3/213 (1.4%) HIV infected children: 0/109 (0%) from mothers under ARV therapy and 3/104 (2.8%) from mothers treated with Nevirapine. All children had recombinant HIV-1 strain (CRF06_CPX) with: minor PR mutations (M36I, K20I) and RT mutations (R211K). Among them, two twins had Non-Nucleoside Reverse Transcriptase Inhibitor mutation (Y18CY). Both mothers acquired a major PR mutation (V8IV), investigated 6 months after a single-dose of Nevirapine. Prevention by single-dose of Nevirapine reduced significantly mother-to-child transmission of HIV, but caused many mutations and resistance to antiretroviral drugs. Based on present study the antiretroviral therapy protocol, together with the artificial-feeding, might represent the ideal strategy to avoid transmission of HIV from mother-to-child. J. Med. Virol. 79:873,879, 2007. © 2007 Wiley-Liss, Inc. [source]

Toxoplasma gondii, HCV, and HBV seroprevalence and co-infection among HIV-positive and -negative pregnant women in Burkina Faso

JOURNAL OF MEDICAL VIROLOGY, Issue 6 2006
Jacques Simpore
Abstract Toxoplasma gondii (T. gondii) infections can cause serious complications in HIV-infected pregnant women, leading to miscarriage, stillbirth, birth defects (e.g., mental retardation, blindness, epilepsy etc.) and could favor or enhance the mother-to-child transmission of HCV, HBV, and HIV vertical transmission. From May 20, 2004 to August 3, 2005, 336 18,45 years aged pregnant women, were enrolled for an investigation of the prevalence of serum antibodies against T. gondii, HCV, HBV, and HIV using ELISA. The prevalence of T. gondii, HCV, and HBV in pregnant women was 25.3%, 5.4%, and 9.8%, respectively and the HIV serostatus (61.6%) seems to be associated with greater prevalence rates of both T. gondii (28.5% vs. 20.2%) and HBV (11.6% vs. 7.0%). Without taking into account HIV, only 65.5% (220 of 336) of the women were not infected with these agents. The co-infection rate between HIV-infected and -negative women was different statistically: T. gondii/HBV 0.048 versus 0.015, T. gondii/HCV 0.014 versus 0.008, and HCV/HBV 0.005 versus 0.008, respectively. The elevated co-infection rate in HIV-positive women demonstrated that they are exposed to T. gondii, HCV, and HBV infections prevalently by sexual contact. J. Med. Virol. 78:730,733, 2006. © 2006 Wiley-Liss, Inc. [source]

Reduction of mother-to-child transmission of HIV at Saint Camille Medical Centre in Burkina Faso

JOURNAL OF MEDICAL VIROLOGY, Issue 2 2006
J. Simpore
Abstract One thousand three hundred and twenty-eight pregnant women with less than 32 weeks of amenorrhea received voluntary counseling and testing at Saint Camille Medical Center from May 1, 2002 to December 30, 2004. Following informed consent and pre-test counseling, HIV screening was performed in 1,202 women. According to the prevention protocol, HIV-positive women received a single dose of Nevirapine (200 mg) during their labor, while their newborn received a single dose of Nevirapine (2 mg/kg) within 72 hr from birth. HIV seroprevalence (11.2%) was higher than in the overall population. One hundred and ninty-three children were born at the end of December 2004; 53 children (27.5%) followed a short breastfeeding protocol for 4 months, while 140 (72.5%) were fed artificially. All the children underwent RT-PCR test for HIV 5,6 months after their birth: 173 (89.6%) were HIV negative whilst 20 children (10.4%) were HIV positive. Out of the 20 positive children 5/53 (9.4%) had received breast milk for 4 months, while the remaining 15/140 (10.7%) had been fed artificially (P,=,0.814). Artificially fed babies (3/140 (2.1%)) and 1/53 (1.9%) of those breast fed for 4 months deceased according to mortality rate of HIV-positive children. This shows that there is no statistically significant difference (P,=,0.648) between the mortality of artificially fed (3/140 or 2.1%) and breast-fed (1/53 or 1.9%) children. Artificially fed children (20/140 (14.3%)) and 5/53 (9.4%) of breast-fed children died within 6,10 months. This figure indicates that there is no significant difference between the mortality rate of artificially and that of breast-fed children (P,=,0.427). Although the HIV prevention program reduced significantly the vertical transmission of HIV at Saint Camille Medical Center, the mortality of artificially fed children was still high due to gastrointestinal diseases. The HIV diagnosis by RT-PCR technique was of great help in the early identification of HIV-infected children. J. Med. Virol. 78:148,152, 2006. © 2005 Wiley-Liss, Inc. [source]

Intrafamilial transmission of hepatitis C virus: a systematic review

JOURNAL OF VIRAL HEPATITIS, Issue 2 2000
Ackerman
To examine the risk of hepatitis C virus (HCV) transmission between patients infected with HCV and their household members (siblings, offspring and parents), as well as their stable heterosexual partners, a systematic search of the MEDLINE database was undertaken for all relevant articles published up to June 1997. English language publications or those supplemented with an English abstract that reported studies concerning hepatitis C, and household, intrafamilial, sexual and intraspousal transmission of HCV, were reviewed. Data from uncontrolled and controlled studies were collected and analysed separately. Studies reporting the exclusive use of first-generation anti-HCV antibodies without supplemental tests were excluded. Pre- or postnatal mother-to-child transmission of HCV and homosexual and heterosexual transmission of HCV among non-permanent couples were not included. Unweighted data from individual studies were pooled for each category of family member. Data were also analysed separately for Japanese and non-Japanese studies because there is evidence that intrafamilial transmission may differ, based on endemicity of the viral infection. Comparisons were drawn only from controlled studies that reported the prevalence of HCV in family members of both HCV-positive and HCV-negative controls. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for each family category. In uncontrolled studies, the pooled prevalence of anti-HCV among 4250 stable sexual contacts of patients with HCV-related chronic liver disease (CLD) was 13.48%, while the pooled prevalence of anti-HCV among 580 stable sexual contacts of patients who contracted HCV as a result of multiple transfusions was 2.41%. In controlled studies, the pooled prevalence of anti-HCV among 175 siblings and household contacts of patients with CLD was 4.0% compared with 0% among 109 contacts of anti-HCV-negative controls (OR 9.75, 95% CI 0.91 ad infinitum). The pooled prevalence of anti-HCV among offspring of Japanese HCV-infected CLD patients was 17% compared with 10.4% among offspring of HCV-negative Japanese controls (OR 1.77, 95% CI 1.21,2.58, P=0.002). The pooled prevalence of anti-HCV among spouses of non-Japanese HCV-infected CLD patients was 15.2% compared with 0.9% in the spouses of non-Japanese HCV-negative controls (OR 20.57, 95% CI 6.05,84.08, P=0.0001). The prevalence of anti-HCV among non-Japanese offspring and Japanese spouses of HCV-infected patients was not increased compared with controls. HCV genotype homology and mutant analysis studies in pairs of HCV-infected patients and their HCV-infected contacts showed that concordant genotype homology was found in 66% of non-sexual contacts and in 74% of sexual contacts. Sequence homology of greater than 92% was found in 19 out of 35 pairs. Hence, evidence exists that familial, non-sexual and sexual transmission of HCV does occur. In Japanese patients, transmission probably occurs in younger family members while, in non-Japanese patients, transmission probably occurs at an older age, after contact with an HCV-infected spouse. [source]

Sociocultural influences on infant feeding decisions among HIV-infected women in rural Kwa-Zulu Natal, South Africa

MATERNAL & CHILD NUTRITION, Issue 1 2005
Lucy N. Thairu msc
Abstract The promotion of exclusive breastfeeding for 6 months, followed by rapid transition to alternative food sources may be an important public health approach to the reduction of mother-to-child transmission of HIV through breastmilk. The basic ethical principle of ,informed choice' requires that HIV positive women are provided with adequate information about their options. However, information is only one factor that affects their decisions. The objective of this ethnographic study was to identify sociocultural influences on infant feeding decisions in the context of a large cohort study designed to assess the impact of a breastfeeding counselling and support strategy to promote exclusive breastfeeding on postnatal transmission of HIV in African women. Following an initial period of exploratory interviewing, ethnographic techniques were used to interview 22 HIV positive women about their views on infant feeding and health. Interviews were tape-recorded, transcribed and analysed with a text analysis program. Five themes of influences on feeding decisions emerged: (1) social stigma of HIV infection; (2) maternal age and family influences on feeding practices; (3) economic circumstances; (4) beliefs about HIV transmission through breastmilk; and (5) beliefs about the quality of breastmilk compared to formula. The study highlights the role of cultural, social, economic and psychological factors that affect HIV positive women's infant feeding decisions and behaviour. [source]

Vitamin A, Mastitis, and Mother-to-Child Transmission of HIV-1 through Breast-feeding: Current Information and Gaps in Knowledge

Micronutrients and Adverse Pregnancy Outcomes in the Context of HIV Infection

NUTRITION REVIEWS, Issue 7 2004
Dr.P.H., Wafaie Fawzi M.B.
HIV infection is a global public health problem, particularly in Africa. Concurrently, micronutrient deficiencies and adverse pregnancy outcomes are prevalent in the same settings. Supplements containing B complex and vitamins C and E were efficacious in reducing adverse pregnancy outcomes, including fetal loss, low birth weight, and prematurity among HIV-infected women; the generalizability of this finding to uninfected women is being examined. There is little encouragement from published studies to provide prenatal vitamin A supplements in HIV infection, particularly in light of significantly higher risk of mother-to-child transmission observed in one trial. The efficacy and safety of prenatal zinc and selenium supplements on these outcomes need to be examined in randomized trials. [source]

Mother-to-Child Transmission of HIV in China and the USA: A Comparative Analysis

Preventing mother-to-child transmission of HIV

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2009
CN Mnyani
HIV transmission from mother-to-child remains a major cause of infant morbidity and mortality in resource-poor settings. There is consensus that women who need antiretroviral treatment should receive this during pregnancy and beyond, and that an appropriate antiretroviral prophylactic regimen should be given to those who do not yet need ongoing therapy. Infant feeding remains a major source of infection and new antiretroviral strategies, for mothers or children, are emerging with the potential to control this. Access to HIV testing and antiretroviral treatment or prophylaxis remain very limited in low resource settings and needs to be expanded. [source]

The AmRo study: pregnancy outcome in HIV-1-infected women under effective highly active antiretroviral therapy and a policy of vaginal delivery

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2007
K Boer
Objective, To explore pregnancy outcome in HIV-1-positive and HIV-negative women, and mother-to-child transmission (MTCT) according to mode of delivery under effective highly active antiretroviral therapy (HAART). Design, Cohort of 143 pregnant HIV-1-infected women including a matched case,control study in a 2:1 ratio of controls to cases (n = 98). Setting, Academic Medical Center in Amsterdam and Erasmus Medical Center in Rotterdam, the Netherlands. Population, Consecutive referred HIV-1 infected pregnant women treated with HAART and matched control not infected pregnant women. Main outcome measures, MTCT, preterm delivery, low birthweight, pre-eclampsia. Results, MTCT was 0% (95% CI 0,2.1%). Seventy-eight percent of HIV-1-infected women commenced and 62% completed vaginal delivery. The calculated number of caesarean sections needed to prevent a single MTCT was 131 or more. Preterm delivery rates were 18% (95% CI 11,27) in women infected with HIV-1 and 9% (95% CI 5,13) in controls (P = 0.03). HAART used at <13 weeks of gestation was associated with a 44% preterm delivery rate compared with 21% when HAART was started at or after 13 weeks and 14% in controls. (Very) low birthweight and incidence of pre-eclampsia were not different between HIV-1 and controls. Conclusions, We have not demonstrated any MTCT after vaginal delivery in women effectively treated by HAART. The HAART-associated increase in preterm delivery rate is mainly seen after first trimester HAART use. [source]

REVIEW: Preventing mother-to-child transmission of HIV: successes and challenges

Factors determining HIV viral testing of infants in the context of mother-to-child transmission

Clinical implications of mother-to-child transmission of HCV

ACTA PAEDIATRICA, Issue 4 2005
Alison M Kesson
Abstract Testing for vertical transmission of hepatitis C virus (HCV) infection in infants and children will enable early identification of the majority of uninfected HCV-exposed infants and children, and will provide significant emotional relief for the parents. [source]

Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter?

ACTA PAEDIATRICA, Issue 8 2003
A Coutsoudis
Aim: To examine infant morbidity risks associated with refraining from breastfeeding where it is used in an attempt to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Methods: The population consisted of infants born to HIV-infected women in South Africa who were participating in a vitamin A intervention trial to prevent MTCT of HIV. Women chose to breastfeed or formula feed their infants according to UNAIDS guidelines. Actual feeding practices and morbidity were recorded at clinic follow-up visits at 1 wk, 6 wk, 3 mo and every 3 mo thereafter until 15 mo of age or cessation of breastfeeding. The infant's HIV status was assessed according to a predetermined algorithm. Results: HIV-infected infants who were never breastfed had a poorer outcome than those who were breastfed; 9 (60%) of those who were never breastfed had 3 or more morbidity episodes compared with 15 (32%) of breastfed children [odds ratio (OR) 4.05, 95% confidence interval (95% CI) 0.91,20.63, p = 0.05]. During the first 2 mo of life, never-breastfed infants (regardless of HIV status) were nearly twice as likely to have had an illness episode than breastfed infants (OR 1.91, 95% CI 1.17-3.13, p = 0.006). Conclusion: The significant extra morbidity experienced in the first few months by all never-breastfed infants and at all times by HIV-infected infants who are not breastfed needs to be considered in all decisions by mothers, health workers and policy makers so as not to offset any gains achieved by decreasing HIV transmission through avoiding breastfeeding. [source]

Prevention of mother-to-child transmission of HIV: reflections on implementation of PMTCT in the developing world

ACTA PAEDIATRICA, Issue 8 2002
C WilfertArticle first published online: 2 JAN 200
No abstract is available for this article. [source]

Prospects of vaccination as a means of preventing mother-to-child transmission of HIV-I,

ACTA PAEDIATRICA, Issue 2 2002
G Biberfeld
Although short-course antiretroviral therapy is efficient in reducing mother-to-child transmission (MTCT) of HIV-1, it does not prevent transmission during the breastfeeding period. There is therefore an urgent need to test various approaches, including HIV-1 vaccination, to try to prevent postnatal transmission of HIV-1 in breastfeeding populations in developing countries. [source]