Prevalence, Risk Factors, and Serotype Distribution of Group B Streptococcus Colonization in HIV-Infected Pregnant Women Living in Belgium: A Prospective Cohort Study

Dauby, Nicolás; Adler, Catherine; Deyi, Véronique Yvette Miendje; Sacheli, Rosalie; Busson, Laurent; Chamekh, Mustapha; Marchant, Arnaud; Barlow, Patricia; Wit, Stéphane De; Levy, Jack S.; Melin, Pierrette; Goetghebuer, Tessa

doi:10.1093/ofid/ofy320

Cited by 5 publications

(7 citation statements)

References 35 publications

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“…Our findings are in agreement with two other prior studies, showing no difference in GBS positivity with HIV viral load greater than or less than 50 copies/mL. 9,10 Further studies are needed to fully characterize the association with detectable viral load and increased risk of GBS rectovaginal colonization. Additionally, our study found no significant differences in the GBS positivity rates among the new diagnosis of HIV during pregnancy vs the established diagnosis of HIV prior to pregnancy.…”

Section: Discussionsupporting

confidence: 93%

“…Our findings are in agreement with two other prior studies, showing no difference in GBS positivity with HIV viral load greater than or less than 50 copies/mL. 9 10 Further studies are needed to fully characterize the association with detectable viral load and increased risk of GBS rectovaginal colonization.…”

Section: Discussionsupporting

confidence: 92%

“…Dauby et al noted a similar rate of GBS positivity in patients with ART initiation before pregnancy vs during pregnancy. 9 These findings are interesting given prior observational studies, showing altered gastrointestinal microbiome in patients on ART therapy. 6 Hypotheses for the mechanisms altering the gastrointestinal microbiome include persistent inflammation in the gastrointestinal tract, latency of the HIV virus in the gastrointestinal tract, and or direct effects of the ART on bacteria in the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

“…6 Despite the evidence of an altered gastrointestinal microbiome in patients on ART, current studies, including the current study, do not show evidence of an increase in GBS colonization in pregnant patients with HIV regardless of the timing of initiation of ART. 9 Our study also investigated alterations in GBS antibiotic sensitivities based on HIV-positive vs HIV-negative status. Given the biological plausibility of alterations in the microbiome of HIV-positive patients, it is also plausible that the microbiome of HIV-positive patients may vary in its antibiotic resistance patterns.…”

Section: Discussionmentioning

confidence: 99%

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Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients

et al. 2021

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Objective The objective of our study is to determine if human immunodeficiency virus (HIV)-positive pregnant patients have a higher rate of group B streptococcus (GBS) rectovaginal colonization compared with HIV-negative pregnant patients. Methods Our study is a multi-site retrospective study performed at Ochsner Louisiana State University-Health Shreveport and Monroe campuses including patients who delivered between December 2011and June 2019. Rates of GBS rectovaginal colonization between HIV-positive pregnant patients were compared with a control group of HIV-negative patients. The control group was age and race matched in a 2:1 fashion. The primary outcome was to investigate rates of GBS rectovaginal colonization. Secondary outcomes included GBS culture antibiotic sensitivities, presence of GBS urinary tract infection, GBS positivity based on HIV viral load, and GBS positivity based on new vs established diagnosis of HIV. Continuous data were analyzed using an unpaired t-test, and categorical data were analyzed using a Chi-squared test. The probability level of <0.05 was set as statistically significant. Results A total of 225 patients were included in the final analysis, 75 HIV-positive and 150 HIV-negative controls. Demographic differences were noted. HIV-positive patients were more likely to deliver preterm and were more likely to deliver via cesarean section. Our primary outcome showed no significant differences in incidence of GBS colonization between HIV-positive patients and control group (n = 31, 41.3% vs n = 46, 30.6%, p = 0.136). Antibiotic resistance patterns showed no significant difference between the two groups. There were no significant differences in GBS positivity based on HIV viral load. Conclusion Our study does not show a statistically significant difference in the incidence of GBS colonization between HIV-positive patients and HIV-negative controls. Key Points

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients

et al. 2021

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Maternal immunization in women living with HIV

Dauby,

Gagneux-Brunon,

Martin

et al. 2023

Aids

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Thanks to widespread use of antiretroviral therapy worldwide, women living with HIV (WLWH) are becoming pregnant and giving birth to HIV-exposed but uninfected (HEU) newborns. Both pregnancy and HIV infection-related factors such as low CD4+ T-cell count or uncontrolled viral load increase the risk of severe infections such as influenza, COVID-19, and others, making maternal immunization a valuable tool to decrease maternal morbidity among WLWH. Vaccines administered during pregnancy may also benefit the health of HEU infants. Indeed, HEU infants suffer from higher risk of morbidity of infectious origin, including respiratory syncytial virus (RSV), group B streptococcus (GBS), pneumococcus and pertussis infections. Maternal pertussis immunization is recommended in various high-income countries but not in many low-middle income countries where HIV prevalence is higher. GBS and RSV vaccines to be administered during pregnancy are currently in late-phase clinical trials in HIV-uninfected women and could represent a valuable tool to decrease morbidity during infancy. Decreased transfer of vaccine-specific IgG, accelerated waning of vaccine-induced antibody responses, linked to persistent maternal immune activation, and blunting of infant immune response to vaccines could hamper vaccine effectiveness among WLWH and HEU infants. Vaccine hesitancy could limit benefits of maternal immunization and strategies to tackle vaccine hesitancy should be part of HIV routine care. The aim of this review is to summarize the current knowledge regarding the immunogenicity and efficacy of available and upcoming vaccines recommended during pregnancy of WLWH.

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Interactive effects of bacterial vaginal colonization and HIV on pregnancy outcomes: A Systematic Review and Meta-analysis

Matovelo,

Goddard,

Sabuni

et al. 2024

Preprint

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Background: The independent impact of HIV and bacterial vaginal colonization on pregnancy outcomes has been documented and is compounded by the burden of rapidly escalating antimicrobial resistance. However, the interactive effect of HIV and lower genital tract bacterial colonization, on pregnancy outcomes has not been thoroughly studied and is examined in our study. Methods: We performed a systematic review and meta-analysis to quantitatively assess the interaction between HIV and vaginal bacterial colonization and associations with birth weight and preterm birth. We searched Ovid MEDLINE, Ovid EMBASE, CINAHL, Scopus, Web of Science, Cochrane Library, African Journals Online, and PubMed databases to identify studies published up to December 31, 2023. We included observational reporting on vaginal colonization with bacterial pathogens stratified by HIV status that reported pregnancy outcomes. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used a modified Newcastle-Ottawa Scale to assess study quality. Meta-analysis was conducted using random-effects modeling in STATA Version 18. Pooled log-odds ratios were calculated. The study protocol was registered in PROSPERO(CRD42023485123). Results: We selected 13 studies, involving 6,073 pregnant women, from 5,807 studies identified. The overall pooled prevalence of bacterial colonization was 26%(95%CI:17.3-37.4). There was no significant effect of HIV status and vaginal colonization on birth weight(OR=1.2, 95%CI:-2.57-2.20, p=0.88) and borderline increased odds of preterm birth (OR=2.64, 95%CI:-0.01-1.94, p=0.05). There was no significant association between HIV status and bacterial colonization(OR=1.08, 95%CI =-0.91-1.07), nor in antimicrobial resistance between pregnant women with HIV and those without. Conclusion: Bacterial colonization is prevalent among pregnant women, but there is no clear evidence to suggest that HIV and bacterial colonization interact to affect birth weight or preterm birth. Research with large sample sizes, strict selection criteria, reliable and valid measurement, adequate control for confounding variables, and birthweight and gestational age at delivery assessment as continuous outcomes are still needed to provide robust evidence.

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Prevalence, Risk Factors, and Serotype Distribution of Group B Streptococcus Colonization in HIV-Infected Pregnant Women Living in Belgium: A Prospective Cohort Study

Cited by 5 publications

References 35 publications

Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients

Group B Streptococcus Rectovaginal Colonization and Resistance Patterns in HIV-Positive Compared to HIV-Negative Pregnant Patients

Maternal immunization in women living with HIV

Interactive effects of bacterial vaginal colonization and HIV on pregnancy outcomes: A Systematic Review and Meta-analysis

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