Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis

Suthar, Amitabh B.; Hui‐Kang, David; Beqiri, Alba; Lorenz-Dehne, Karl; McClure, Craig; Duncombe, Chris

doi:10.2471/blt.12.107003

Cited by 67 publications

(58 citation statements)

References 41 publications

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“…However, budget constraints due to the global economic slowdown make it more difficult for governments to effectively fund multiple competing social and health issues (Bach Xuan Tran, 2013). Furthermore, the limitations of certain health services delivery can also negatively affect the ability to achieve the MDGs (Suthar et al, 2012). In 2009, 49% of pregnant women in low and middle-income countries did not attend the minimum number of antenatal care (ANC) visits recommended by the World Health Organization (WHO) to prevent or manage the complications of pregnancy and support safe delivery (UN, 2011).…”

Section: Literature Reviewmentioning

confidence: 99%

The Effects of Heavily Indebted Poor Countries Initiative on the Millennium Development Goals for Health

Ondoa

2016

International Journal of Public Administration

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The objective of this study is to investigate the impact of Heavily Indebted Poor Countries Initiative (HIPC) on the attainment of the health millennium development goals (MDGs) in Africa and identify other correlates of health MDGs. This way, the paper uses data from the World Bank and employs the difference in difference (DID) approach to estimate the impact of HIPC on health MDGs and to identify other determinants of health MDG attainment. The results show that the impact of HIPC on health MDGs is positive. Specifically, due to HIPC, the level of the following health MDG indicators decreased: mortality rate (infant); mortality rate (neonatal); incidence of tuberculosis; prevalence of HIV/AIDS, and mortality rate under five. However, the incidence of tuberculosis (all forms) registered an increase in Africa, even in treated groups. Our findings also indicate that MDGs for health will not be attained simultaneously because some variables that reduce mortality such as GDP per capita, natural resources and education cause HIV/AIDS.

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Section: Literature Reviewmentioning

confidence: 99%

The Effects of Heavily Indebted Poor Countries Initiative on the Millennium Development Goals for Health

Ondoa

2016

International Journal of Public Administration

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“…Antiretroviral therapy (ART) treatment during pregnancy has drastically reduced MTCT to low rates (2)(3)(4). Despite significant efforts to increase ART availability to HIV-infected pregnant women in low-and middle-income countries, as many as 49% of women do not attend the minimum antenatal care visit (ANC) as defined by the World Health Organization, and up to 65% of HIV-infected women from these areas who attend ANC visits do not receive optimal ART treatments during pregnancy (5). While ART during pregnancy has drastically reduced MTCT incidence, even under optimal prophylactic ART regimens, pediatric HIV infections can still occur (4).…”

Section: Importancementioning

confidence: 99%

Maternal Binding and Neutralizing IgG Responses Targeting the C-Terminal Region of the V3 Loop Are Predictive of Reduced Peripartum HIV-1 Transmission Risk

Martinez

Vandergrift²,

Douglas³

et al. 2017

J Virol

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The development of an effective maternal HIV-1 vaccine that could synergize with antiretroviral therapy (ART) to eliminate pediatric HIV-1 infection will require the characterization of maternal immune responses capable of blocking transmission of autologous HIV to the infant. We previously determined that maternal plasma antibody binding to linear epitopes within the variable loop 3 (V3) region of HIV envelope (Env) and neutralizing responses against easy-to-neutralize tier 1 viruses were associated with reduced risk of peripartum HIV infection in the historic U.S. Woman and Infant Transmission Study (WITS) cohort. Here, we defined the fine specificity and function of the potentially protective maternal V3-specific IgG antibodies associated with reduced peripartum HIV transmission risk in this cohort. The V3-specific IgG binding that predicted low risk of mother-to-child-transmission (MTCT) was dependent on the C-terminal flank of the V3 crown and particularly on amino acid position 317, a residue that has also been associated with breakthrough transmission in the RV144 vaccine trial. Remarkably, the fine specificity of potentially protective maternal plasma V3-specific tier 1 virus-neutralizing responses was dependent on the same region in the V3 loop. Our findings suggest that MTCT risk is associated with neutralizing maternal IgG that targets amino acid residues in the C-terminal region of the V3 loop crown, suggesting the importance of the region in immunogen design for maternal vaccines to prevent MTCT. IMPORTANCE Efforts to curb HIV-1 transmission in pediatric populations by antiretroviral therapy (ART) have been highly successful in both developed and developing countries. However, more than 150,000 infants continue to be infected each year, likely due to a combination of late maternal HIV diagnosis, lack of ART access or adherence, and drug-resistant viral strains. Defining the fine specificity of maternal humoral responses that partially protect against MTCT of HIV is required to inform the development of a maternal HIV vaccine that will enhance these responses during pregnancy. In this study, we identified amino acid residues targeted by potentially protective maternal V3-specific IgG binding and neutralizing responses, localizing the potentially protective response in the C-terminal region of the V3 loop crown. Our findings have important implications for the design of maternal vaccination strategies that could synergize with ART during pregnancy to achieve the elimination of pediatric HIV infections.KEYWORDS HIV, mother-to-child transmission, V3, antibodies

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“…With this new approach, nearly 90% of ART-eligible women accessed treatment; this is considerably higher than data reported in the literature, and is very encouraging. 3,7 The study adds evidence for rapidly scaling up ART integration into other facilities in Zimbabwe and elsewhere. It is also in line with the vision of a world where no child will be born with HIV by 2015.…”

Section: Discussionmentioning

confidence: 84%

“…2 Achieving a high uptake of ART is thus essential to reduce transmission to infants, 3 to provide treatment for HIV-infected women and to meet the 2015 Millennium Development Goals of reducing child mortality, improving maternal health and combating HIV/acquired immunedefi ciency syndrome. 4 By the end of 2009, less than 50% of pregnant women in Zimbabwe were undergoing HIV testing, 5 and even more worrying was that ART uptake among those who were eligible had been unacceptably low, at 4%.…”

Section: Discussionmentioning

confidence: 99%

A ‘one-stop shop’ approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?

Gunguwo

Zachariah

Bissell

et al. 2013

public health action

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hospital in Zimbabwe. This meant that women could receive antenatal care, HIV testing, counselling, CD4 testing and ART within the same clinic-a 'one-stop shop' approach.We hypothesised that a one-stop shop approach would positively impact uptake by facilitating access to ART. Identifying those who did not access ART despite this initiative would also be important to improve equity. Two recent meta-analyses showed that integration signifi cantly increased ART uptake. 3,7 A PubMed search revealed no publications on the infl uence of a one-stop shop approach combined with task-shifting of ART initiation to midwives.

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Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis

Cited by 67 publications

References 41 publications

The Effects of Heavily Indebted Poor Countries Initiative on the Millennium Development Goals for Health

The Effects of Heavily Indebted Poor Countries Initiative on the Millennium Development Goals for Health

Maternal Binding and Neutralizing IgG Responses Targeting the C-Terminal Region of the V3 Loop Are Predictive of Reduced Peripartum HIV-1 Transmission Risk

A ‘one-stop shop’ approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?

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