Mother to child transmission of HIV: What works and how much is enough?

Stevens, Jennifer; Lyall, Hermione

doi:10.1016/j.jinf.2014.07.018

Cited by 21 publications

(11 citation statements)

References 8 publications

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“…Evaluation in pregnant women will be a crucial component of new ZIKV interventions and the development of innovative approaches to conduct these studies ethically may benefit maternal health more generally. There are currently very few effective treatments to prevent the vertical transmission of viral infections during pregnancy, although some antiviral therapies that reduce viral burden in the mother, such as antiretroviral therapies in HIV-positive women, can reduce viral loads to lessen the risk of vertical transmission 90,91 . Developing new therapeutic strategies to prevent vertical transmission of ZIKV and other TORCH pathogens will require a better understanding of the mechanisms that are used by these microorganisms to cross the placenta and cause fetal disease.…”

Section: Is Zikv a Torch Pathogen?mentioning

confidence: 99%

Zika virus — reigniting the TORCH

2016

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The recent association between Zika virus (ZIKV) infection during pregnancy and fetal microcephaly has led to a renewed interest in the mechanisms by which vertically transmitted microorganisms reach the fetus and cause congenital disease. In this Opinion article, we provide an overview of the structure and cellular composition of the human placenta and of the mechanisms by which traditional 'TORCH' pathogens (Toxoplasma gondii, other, rubella virus, cytomegalovirus and herpes simplex virus) access the fetal compartment. Based on our current understanding of ZIKV pathogenesis and the developmental defects that are caused by fetal ZIKV infection, ZIKV should be considered a TORCH pathogen and future research and public health measures should be planned and implemented accordingly.

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Section: Is Zikv a Torch Pathogen?mentioning

confidence: 99%

Zika virus — reigniting the TORCH

2016

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“…The use of combination antiretroviral therapy (cART) during pregnancy has resulted in a dramatic reduction in HIV motherto-child transmission. [1][2][3] The use of cART is generally considered safe, with the benefits of HIV prevention far exceeding potential safety concerns from in utero exposure to these drugs. 1,[4][5][6][7] However, there is still a continued need to monitor HIV-exposed, uninfected infants for potential adverse effects from in utero and postnatal exposure to these therapies.…”

Section: Introductionmentioning

confidence: 99%

Infant peripheral blood repetitive element hypomethylation associated with antiretroviral therapyin utero

et al. 2015

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The use of combination antiretroviral therapy (cART) to prevent HIV mother-to-child transmission during pregnancy and delivery is generally considered safe. However, vigilant assessment of potential risks of these agents remains warranted. Epigenetic changes including DNA methylation are considered potential mechanisms linking the in utero environment with long-term health outcomes. Few studies have examined the epigenetic effects of prenatal exposure to pharmaceutical agents, including antiretroviral therapies, on children. In this study, we examined the methylation status of the LINE-1 and ALU-Yb8 repetitive elements as markers of global DNA methylation alteration in peripheral blood mononuclear cells obtained from newborns participating in the Pediatric HIV/AIDS Cohort Study SMARTT cohort of HIV-exposed, cART-exposed uninfected infants compared to a historical cohort of HIV-exposed, antiretroviral-unexposed infants from the Women and Infants Transmission Study Cohort. In linear regression models controlling for potential confounders, we found the adjusted mean difference of AluYb8 methylation of the cART-exposed compared to the -unexposed was -0.568 (95% CI: -1.023, -0.149) and for LINE-1 methylation was -1.359 (95% CI: -1.860, -0.857). Among those exposed to cART, subjects treated with atazanavir (ATV), compared to those on other treatments, had less AluYb8 methylation (-0.524, 95% CI: -0.025, -1.024). Overall, these results suggest a small but statistically significant reduction in the methylation of these repetitive elements in an HIV-exposed, cART-exposed cohort compared to an HIV-exposed, cART-unexposed historic cohort. The potential long-term implications of these differences are worthy of further examination.

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“…Several NNRTI drugs have been evaluated as PrEP agents. Nevirapine is an important agent for the prevention of mother-to-child transmission of HIV infection [6]. UC781, MIV-150, and dapivirine have all been evaluated in gel or intravaginal ring formulations [7][8][9].…”

Section: Preclinical Developmentmentioning

confidence: 99%