Mother-to-child transmission of human immunodeficiency virus (HIV) among HIV-infected pregnant women on highly active anti-retroviral therapy with premature rupture of membranes at term

Eleje, George Uchenna; Edokwe, Emeka Stephen; Ikechebelu, Joseph Ifeanyichukwu; Onubogu, Chinyere Ukamaka; Ugochukwu, EF; Okam, Princeston Chukwuemeka; Ibekwe, Adaobi Maryann

doi:10.1080/14767058.2017.1279600

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…Of note is the performance of the Chorioquick test in triple positive results which could be beneficial in obstetric practice: when the combined tests were all positive, the specificity and PPVs were 100.0% in all categories of women in all gestations. These predictive values were superior to what were reported in previous studies …”

Section: Discussioncontrasting

confidence: 86%

“…These predictive values were superior to what were reported in previous studies. [20][21][22][23][24][25] Chorioquick and histological chorioamnionitis were only discordant in five (6.8%) cases, while Chorioquick and clinical chorioamnionitis were discordant in 20 (27.4%) cases at repeated assessments. Thus, it could be concluded that a significant association exists between women who tested positive for Chorioquick and neonatal admission of the infant to the NICU.…”

Section: Discussionmentioning

confidence: 97%

“…This was expected, as infection is a known cause or consequence of PPROM and the IL‐6 in Chorioquick is a marker of inflammation or infection, since IL‐6 is a proinflammatory cytokine. Despite its poor predictive values, chorioamnionitis can be commonly diagnosed using clinical assessment, especially in low‐ to middle‐income settings . This could further justify the introduction of the Chorioquick test in obstetric practice because placental pathology cannot be evaluated prior to delivery.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

Eleje

Ukah

Onyiaorah

et al. 2020

Intl J Gynecology & Obste

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Objective To determine the accuracy of a semi‐quantitative interleukin‐6 (IL‐6) vaginal secretion rapid test (Chorioquick) for detecting chorioamnionitis in women with premature rupture of membranes (PROM). Methods A prospective cohort study in five tertiary hospitals in Nigeria involved women with confirmed PROM at term and preterm PROM with or without suspected chorioamnionitis from August 1, 2017, to October 31, 2018. Cervicovaginal fluid samples were tested for chorioamnionitis using the Chorioquick test. Samples were repeated at decision to deliver. The test was considered positive if at least the indicator ‘IL‐6 low’ of the three Chorioquick biomarkers (low, medium, high) was positive, or negative if none of the biomarkers were positive. Chorioamnionitis was histologically confirmed post‐delivery using three tissue samples. Primary outcome measures were sensitivity, specificity, and accuracy. Results Of 73 women, on histological confirmation, 39 were true positive and 29 were true negative (for chorioamnionitis) to the Chorioquick test at repeat assessment. Overall, the Chorioquick test had a sensitivity of 97.5% (95% confidence interval [CI] 85.3–99.9), specificity 87.9% (70.9–96.0), and accuracy 93.2% (79.5–99.1). Sub‐group analysis of women <37 weeks of pregnancy showed a sensitivity of 100.0% (95% CI 83.4–100.0), specificity of 91.3% (70.5–98.5), and accuracy of 95.8% (82.5–99.5). Triple positive samples were 100.0% specific in all gestations. Conclusion Chorioquick showed favorable utility for detecting chorioamnionitis in PROM and could be a reliable, non‐invasive rapid tool in a real‐world clinical setting.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

Eleje

Ukah

Onyiaorah

et al. 2020

Intl J Gynecology & Obste

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“…About 20% of children vertically infected with HCV develop active infection [ 20 ]. In addition, following childbirth, most untreated HIV infected children do not live to see their first birthday, with greater rapid deterioration in those coinfected with Hepatitis B and C viruses [ 21 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, seroconversion and mother-to-child transmission of dual and triplex infections of HIV, hepatitis B and C viruses among pregnant women in Nigeria: study protocol

et al. 2020

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Background Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available. Objectives To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. Method A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C virus infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007–23/01/2020). Conclusion Pregnant women with multiple of HIV, HBV and HCV infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, and powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

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“…[20] In addition, following childbirth, most untreated HIV infected children do not live to see their rst birthday, with greater rapid deterioration in those coinfected with Hepatitis B and C viruses. [21][22][23] Elimination of MTCT of HIV and hepatitis B and C infection in Nigeria requires the implementation of feasible, culturally acceptable and sustainable interventions and policies that is based on adequate and reliable in-country evidence and data. Unfortunately, a nationally representative data on prevalence of triplex infection, rate of new infection and MTCT rate based on appropriately design and power study is lacking.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Seroconversion and Mother-To-Child Transmission of Dual and Triplex Infections of HIV, Hepatitis B and C Viruses Among Pregnant Women in Nigeria: Study Protocol

Eleje

Mbachu

Ogwaluonye

et al. 2020

Preprint

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Background: Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available.Objectives: To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. Method: A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007-23/01/2020).Conclusion: Pregnant women with multiple of HIV, HBV and C infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

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Mother-to-child transmission of human immunodeficiency virus (HIV) among HIV-infected pregnant women on highly active anti-retroviral therapy with premature rupture of membranes at term

Abstract: MTCT rate was 0% following term PROM and in women without PROM. Since maternal HIV-1 viral load was not assessed, we need to be critical while interpreting the findings.

Cited by 6 publications

References 19 publications

Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

Prevalence, seroconversion and mother-to-child transmission of dual and triplex infections of HIV, hepatitis B and C viruses among pregnant women in Nigeria: study protocol

Prevalence, Seroconversion and Mother-To-Child Transmission of Dual and Triplex Infections of HIV, Hepatitis B and C Viruses Among Pregnant Women in Nigeria: Study Protocol

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