Early Initiation of ARV During Pregnancy to Move towards Virtual Elimination of Mother-to-Child-Transmission of HIV-1 in Yunnan, China

Meyers, Kathrine; Qian, Haoyu; Wu, Yingfeng; Lao, Yunfei; Chen, Qingling; Dong, Xingqi; Li, Huiqin; Yang, Yiqing; Jiang, Chengqin; Zhou, Zengquan

doi:10.1371/journal.pone.0138104

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…However, their analysis typically requires more sophisticated epidemiological approaches in order to control for confounding by indication (eg., when clinicians prescribe certain ART regimens depending on health or other characteristics of their patients) and possible time trends in prescribing patterns. Confounding by indication is particularly important when certain regimens are prescribed specifically among women with low CD4 count (such as NVP) or among women initiating ART late in pregnancy (such as INSTIs) as both low CD4 count and initiation of ART late in the third trimester are associated with poorer perinatal outcomes and MTCT [77]. …”

Section: Biostatistical Approaches To Evaluation Of Surveillance Datamentioning

confidence: 99%

Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges

Zash

Williams

Sibiude

et al. 2016

Expert Opinion on Drug Safety

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Introduction The use of antiretroviral therapy (ART) in pregnancy to prevent vertical HIV transmission has been one of the most successful public health programs in the last decade. As a result, an unprecedented number of women are taking ART at conception and during pregnancy. Given few randomized studies evaluating safety of different ART regimens in pregnancy, ongoing drug safety surveillance is critical. Areas Covered This review aims to provide a rationale for ART drug safety surveillance, describe changing patterns of ART use and summarize current surveillance efforts in both low-resource and high-resource settings. Additionally, biostatistical approaches to and challenges in analysis of observational surveillance data are discussed. Expert Opinion The global landscape of ART use in pregnancy is rapidly increasing and evolving. Any increase in adverse effects of in-utero exposure to ART has the potential to reduce the impact of improvements in infant morbidity and mortality gained from decreased vertical HIV transmission. ART drug safety surveillance should therefore be a critical piece of programs to prevent mother to child transmission in both high- and low-resource settings. Current surveillance efforts could be strengthened with long-term follow-up of exposed children, pooling of data across cohorts and standardized approaches to analysis.

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Section: Biostatistical Approaches To Evaluation Of Surveillance Datamentioning

confidence: 99%

Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges

Zash

Williams

Sibiude

et al. 2016

Expert Opinion on Drug Safety

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“…9 Similar results were found a study by Meyers et al where 43% pregnancies were between seroconcordant couples, 55.2% between serodiscordant couples. 16 In our study, 30.1% serodiscordance can be explained on the basis of the fact that in many partners who are recently tested may be in the window period of HIV and hence, will test negative. The coexistence of various biological cal factors along with the social scenario explains this situation.…”

Section: Resultsmentioning

confidence: 56%

“…Fourpatients came directly in labor. In the study by Aishat et al 16.4% of patients had less than 3 ANC visits, majority patients that is 52.7% had 4-8 ANC. 19 A high percentage of seropositive women following up regularly in ANC clinic reflects effective counseling services provided under the PMTCT Programme, showing an inclination towards health seeking behavior among this population.…”

Section: Resultsmentioning

confidence: 91%

Multidrug Regimen for Prevention of Mother-to-child Transmission in Human Immunodeficiency Virus-positive Mothers in India—From Prevention toward Elimination

Daver¹,

Chhabra²

2017

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…In Cameroon, the prevalence of HIV is about 3.7% in 2018 and about 510.000 people is living with HIV AIDS. Timely and appropriate initiation of antiretroviral treatment for HIV-positive subjects reduces morbidity and mortality associated with infections [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Performance of the BD FACSPresto near to patient Analyzer in comparison with representative conventional CD4 instruments in Cameroon.

Sagnia¹,

Ghomsi²,

Gutiérrez³

et al. 2020

Preprint

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Background In the context of scaling the viral load in resource limited settings, following HIV infected patient’s adults and children with CD4+ T-lymphocyte count still very important in settings where the decentralization of treatment still has some challenges. Effective HIV monitoring in these resource-constrained settings needs affordable and reliable CD4+ T lymphocytes enumeration methods. We investigated the validity of a BD FACSPresto POC which is a dedicated system for enumeration that uses immunofluorescent technologies. In this study, we have assessed the sensitivity, specificity and correlation between most representative flow cytometry instruments present in Cameroon with more than 5000 CD4 T cells tests per year including FACSCalibur, FACSCount, and PIMA POC from Becton dinkinson and ALERE respectively. Methods 268 patients aged from 1 to 72 years old were enrolled and included in the study after inform consent. The BD FACSPresto POC CD4+ T cell technology was placed at CIRCB and operated by technician staff. HIV infected patients were from Chantal BIYA international reference Center (CIRCB), Centre de Sante Catholique de NKOLODOM, Centre de Sante Catholique de BIKOP and CASS de Nkolndongo – Yaounde We compared the accuracy of the BD FACSPresto and three existing reference technologies with more than 5000 tests per year like FACSCalibur, FACSCount and PIMA according to the number of CD4 test done per year and their repartition in the country. Bland – Altman method and correlation analysis were used to estimate mean bias and 95% limits of agreement and to compare the methods, including analysis by subgroup of participant gestational age. In addition sensitivity and specificity were determined. Statistical significance was set at p-value < 0.05 Results The BD FACSPresto POC system has excellent precision, accuracy and linearity for CD4+ T lymphocytes enumeration. Good correlations were obtained between the BD FACSPresto poc system and other single platform methods. Bland–Altman plots showed interchangeability between two machines mean bias BD-FACSPresto vs PIMA= -126,522(-161,221 to -91,822) BD-FACSPresto vs FACSCount= -38,708 (-58,935 to -18,482) and FACSPresto vs FACSCALIBUR= 0,791(-11,908 to 13,491). Mean difference with Absolute CD4+ T-lymphocyte values obtained from the BD FACSPresto system correlated well with PIMA, FACSCount, and FACSCalibur method with R 2 equal to 0.88, 0.92 and 0.968 respectively with P < 0.001 for all. The mean comparison between values obtained from BD FACSPresto with PIMA, FACSCount, and FACSCalibur using paired T test give P=0.17, P=0.5 and P=0.6 respectively meaning that there is no significant differences between values obtained with BD FACSPresto and PIMA, FACSCount or FACSCalibur CD4 enumeration machines. Further analysis revealed close agreement between all the three instruments with no significant difference between the forth methods (P=0.91) Conclusion This BD-FACSPresto POC system is a simple, robust and reliable system for enumeration of absolute and percentage of CD4+ T-lymphocytes especially suitable for remote areas with limited resources. Having one BD-FACSPresto POC system easy to use, should reduce the cost and thus increase and improved access to CD4 testing for HIV infected patients in resource-constrained countries. BD-FACSPresto POC CD4 will enable reduction in patient time and improve the overall quality of ART service count and may improve test access in remote areas. This technology can allow for greater decentralization and wider access to CD4 testing and ART

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Early Initiation of ARV During Pregnancy to Move towards Virtual Elimination of Mother-to-Child-Transmission of HIV-1 in Yunnan, China

Cited by 22 publications

References 23 publications

Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges

Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges

Multidrug Regimen for Prevention of Mother-to-child Transmission in Human Immunodeficiency Virus-positive Mothers in India—From Prevention toward Elimination

Performance of the BD FACSPresto near to patient Analyzer in comparison with representative conventional CD4 instruments in Cameroon.

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