HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study

Abstract

The human immunodeficiency virus (HIV) remains a leading cause of maternal morbidity and mortality in Sub-Saharan Africa. Prevention of mother-to-child transmission (PMTCT) has proven an effective strategy to end paediatric infections and ensure HIV-infected mothers access treatment. Based on cross-sectional data collected from June 2008 to May 2013, we assessed changes in HIV prevalence, risk factors for HIV, provision of PMTCT antiretroviral treatment (ART), and the association between HIV infection, birth outcomes and maternal characteristics at the Simão Mendes National Hospital, Guinea-Bissau's largest maternity ward. Among 24,107 women, the HIV prevalence was 3.3% for HIV-1, 0.8% for HIV-2 and 0.9% for HIV-1/2. A significant decline in HIV-1, HIV-2, and HIV-1/2 prevalence was observed over time. HIV infection was associated with age and ethnicity. A total of 85% of HIVinfected women received ART as part of PMTCT, yet overall treatment coverage during labour and delivery declined significantly for both mothers and infants. Twenty-two percent of infants did not receive treatment, and 67% of HIV-2-infected mothers and 77% of their infants received ineffective non-nucleoside reverse transcriptase inhibitors for PMTCT. Maternal HIV was associated with low birth weight but not stillbirth. Inadequate continuity of care and ART coverage present challenges to optimal PMTCT in Guinea-Bissau. Despite remarkable progress over the past decade, Sub-Saharan Africa (SSA) continues to have the highest global prevalence of HIV. Women remain disproportionately at risk of acquiring HIV, with an estimated 59% of all new infections occurring amongst females 1. Furthermore, HIV remains one of the leading causes of mortality among women of reproductive age in the region 2. In 2017, an estimated 1.3 million pregnant women were living with HIV, and 130,000 infants were infected with HIV in SSA 3 .

Effects of HIV Infection on Pregnancy Outcomes Among Women Attending Antenatal Care in Referral Hospitals of the Amhara Regional State, Ethiopia: A Prospective Cohort Study

“…90 Finally, the multivariate Poisson regression model revealed that maternal HIV infection was not associated with stillbirth. Similar findings were reported from studies in Bissau, Guinea-Bissau, 70 a study in Sub-Saharan Africa, 91 , 92 and USA. 93 …”

“…The incidence of LBW in this study was higher than studies in other parts of Ethiopia 31 Guinea-Bissau 70 Uganda, 71 Lesotho, 9 South Africa, 63 Amsterdam, 72 China, 12 , 27 and Canada. 22 The difference in the estimated incidence might be due to differences in study sites in that almost all of these studies were conducted at a single study site while our study was a multi-centre study where most of the complicated pregnancies were referred for better management.…”

Discovery and Mechanistic Investigation of Piperazinone Phenylalanine Derivatives with Terminal Indole or Benzene Ring as Novel HIV-1 Capsid Modulators

“…The rapid spread of AIDS and its high mortality rate threaten human health and social development. HIV contains two species: HIV-1 is the predominant pathogenic pathogen, but the danger of HIV-2 infection is increasing and has been discovered globally [ 3 , 4 ]. Current combination antiretroviral therapy (cART) and, in light of frequent mutations within the retrovirus, available antivirals can delay disease progression and suppress viral load in patients; however, a cure is currently not possible due to latent viral pools induced by cART [ 5 , 6 , 7 ].…”

The influence of viral protein R amino acid substitutions on clinical outcomes in people living with HIV: A systematic review

“…4 Human immunodeficiency virus is a genetically diverse pathogen due to high replication rates, error-prone reverse transcriptase and recombination events that could occur during viral replication. [5][6][7] Two types of HIV exist, HIV-1 and HIV-2, of which HIV-1 is more prevalent [8][9][10] and is categorised into groups M, N, O and P. [11][12][13][14][15][16] As reviewed by Sharp and colleagues, HIV-1 group M is the more geographically abundant group than other HIV-1 groups. 17 Furthermore, HIV-1 group M consists of viral subtypes A, B, C, D, F, G, H, J and K. 11 Furthermore, subtypes A and F have sub-subtypes, namely A1-4 and F1-2, respectively.…”