Maternal Tuberculosis: A Risk Factor for Mother-to-Child Transmission of Human Immunodeficiency Virus

Gupta, Amita; Bhosale, Ramesh; Kinikar, Arti; Gupte, Nikhil; Bharadwaj, Renu; Kagal, Anju; Joshi, Suvarna; Khandekar, Medha; Karmarkar, Alaka; Kulkarni, Vandana; Sastry, Jayagowri; Mave, Vidya; Suryavanshi, Nishi; Thakar, Madhuri; Kulkarni, Smita; Tripathy, Srikanth; Sambarey, Pradeep; Patil, Sandesh; Paranjape, Ramesh; Bollinger, Robert C.; Jamkar, Arun

doi:10.1093/jinfdis/jiq064

Cited by 71 publications

(27 citation statements)

References 15 publications

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“…The most common organisms associated with pneumonia, Streptococcus and Haemophilus, occur in HIV patients at similar rates to those in the non-HIV population. 45 An estimated 30% of HIV-infected persons worldwide have latent MTB. Methicillin-resistant Staphylococcus aureus is associated with a severe, necrotizing pneumonia and increased mortality in HIV-positive patients.…”

Section: Bacterial Ois and Pneumoniamentioning

confidence: 99%

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Opportunistic Infections in Women With HIV AIDS

Lazenby

2012

Clinical Obstetrics &Amp; Gynecology

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Women account for half of the global human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infections. Heterosexual contact is the leading risk factor in women. Over 50% of patients are significantly immunosuppressed at the time of diagnosis. Women with advanced HIV infection are at a risk for opportunistic infections (OIs). OIs lead to significant morbidity and cost. Some of OIs may impact women more significantly than men, that is, human papillomavirus infection and cervical cancer. OIs during pregnancy can increase the risk of maternal-to-child transmission of HIV and some OIs, such as Hepatitis C. This chapter will review of OIs that are most important in women's health.

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Section: Bacterial Ois and Pneumoniamentioning

confidence: 99%

“…Concomitant treatment of HIV and MTB causes concern for drug interactions, overlapping drug toxicities, and IRIS. 45 HIV-positive pregnant women should be screened and treated for latent MTB. Delaying ARV therapy 4 to 12 weeks after MTB treatment initiation does not impact overall survival.…”

Section: Bacterial Ois and Pneumoniamentioning

confidence: 99%

Opportunistic Infections in Women With HIV AIDS

Lazenby

2012

Clinical Obstetrics &Amp; Gynecology

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“…Studies have associated several maternal HIV coinfections (including cytomegalovirus infection, hepatitis C virus infection, active tuberculosis and malaria) with adverse pregnancy and infant health outcomes, and maternal malaria and tuberculosis coinfections are established risk factors for MTCT of HIV and infant mortality . In contrast, data linking maternal HIV/HBV coinfection to adverse pregnancy outcomes such as preterm labour and low birth weight are inconclusive , and the impact of maternal HIV/HBV coinfection on MTCT of HIV and infant mortality remains unclear . Definitive studies to establish the role of maternal HIV/HBV coinfection in HBV‐endemic RLSs are needed, and their findings may result in the prioritizing of changes to local standard of care practices, including routine antepartum screening for HBV in HIV‐infected women and timely vaccination/treatment of HIV/HBV‐coinfected women and their exposed infants.…”

Section: Introductionmentioning

confidence: 99%

Impact of maternal hepatitis B virus coinfection on mother‐to‐child transmission of HIV

et al. 2014

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Background Despite high hepatitis B virus (HBV) endemicity in various resource-limited settings (RLS), the impact of maternal HIV-HBV coinfection on infant health outcomes has not been defined. Method This study determined the seroprevalence of HBV coinfection among HIV-infected pregnant women enrolled in the India six-week extended-dose nevirapine (SWEN) trial. The impact of maternal HIV-HBV coinfection on MTCT of HIV and infant mortality was assessed using univariate and multivariate logistic regression analysis. Results Among 689 HIV-infected pregnant Indian women, 32 (4.6%) had HBV coinfection (95% confidence interval [CI] 3.4, 5.3). HBV DNA was detectable in 18 (64%) of 28 HIV-HBV coinfected women; the median HBV viral load was 155 copies/mL (interquartile range [IQR] < 51–6741). Maternal HIV-HBV coinfection did not increase HIV transmission (adjusted odds ratio [aOR] 1.06, 95% CI 0.30, 3.66; p= 0.93). Increased odds of all-cause infant mortality was noted (aOR 3.12, 95% CI 0.67, 14.57; p=0.15), but was not statistically significant. Conclusion The prevalence of active maternal HBV co-infection in HIV-infected pregnant women in India was 4.6%. HIV-HBV coinfection was not independently associated with HIV transmission.

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“…5,6 TB has also been associated with increased risk of HIV transmission from mother to child. 7 In a meta-analysis of TB symptom screening algorithms coordinated by World Health Organization (WHO), the best performing rule was a 4-symptom screen using one of any of the following: cough in the last 24 hours, fever, night sweats, and weight loss. This 4-symptom screen rule had a sensitivity of 90.1% in a clinic setting and negative predictive value of 98.3%, assuming TB prevalence of 5% among people living with HIV.…”

Section: Introductionmentioning

confidence: 99%

“…CD4 cell count (greater or less than 200 cells/mL) had little impact on the sensitivity or specificity of this symptom screen. [7][8][9][10] The WHO guidelines thus recommend screening for TB using the presence of cough of any duration, fever, night sweats, and weight loss, and collecting sputum for testing from symptomatic persons with any of the symptoms above. 8 Several studies have demonstrated the efficacy of active case finding (ACF) for identification of active TB enabling initiation of appropriate medical therapy, and provision of isoniazid preventive therapy (IPT) to prevent TB.…”

Section: Introductionmentioning

confidence: 99%