Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan

doi:10.1111/j.1360-0443.2011.03609.x

Cited by 18 publications

(15 citation statements)

References 53 publications

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“…In the present study, women with histories of injecting drug use were at increased risk of not receiving any antenatal ART, as reported previously in Ukraine 32 and also in the Russian Federation. 33 However, such women who had initiated ART were no less likely to have received cART than the women who had no histories of injecting drug use.…”

Section: Researchsupporting

confidence: 72%

Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine

Bailey

Townsend²,

Semenenko³

et al. 2013

Bull. World Health Organ.

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Section: Researchsupporting

confidence: 72%

Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine

Bailey

Townsend²,

Semenenko³

et al. 2013

Bull. World Health Organ.

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“…In 2015, 97 young people transferred from paediatric to adult HIV care nationally in Ukraine at age 18 years [31] while there were 2764 children aged ≤14 years in HIV care [23]. PHIV children growing up in EE have high prevalence of exposure to maternal drug use (26% in the Ukraine Paediatric HIV Cohort [32]) due to poor PMTCT access among women who inject drugs [29,33] with potential for other related impacts on health – for example, hepatitis C co-infection, exposure to tuberculosis, and long-term sequelae of preterm delivery. Maternal IDU and perinatal HIV transmission have both been linked to infant abandonment [34], and high and increasing number of AIDS deaths in the adult population from 38,000 to 47,000 annually between 2010 and 2015 [35]) contribute to the number of PHIV children growing up without family support in EE.…”

Section: Resultsmentioning

confidence: 99%

Adolescents with HIV and transition to adult care in the Caribbean, Central America and South America, Eastern Europe and Asia and Pacific regions

Bailey

Cruz

Songtaweesin

et al. 2017

Journal of the International AIDS Society

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Introduction: The HIV epidemics in the Caribbean, Central America and South America (CCASA), Eastern Europe (EE) and Asia and Pacific (AP) regions are diverse epidemics affecting different key populations in predominantly middle-income countries. This narrative review describes the populations of HIV-positive youth approaching adolescence and adulthood in CCASA, EE and AP, what is known of their outcomes in paediatric and adult care to date, ongoing research efforts and future research priorities.Methods: We searched PubMed and abstracts from recent conferences and workshops using keywords including HIV, transition and adolescents, to identify published data on transition outcomes in CCASA, EE and AP. We also searched within our regional clinical/research networks for work conducted in this area and presented at local or national meetings. To give insight into future research priorities, we describe published data on characteristics and health status of young people as they approach age of transition, as a key determinant of health in early adulthood, and information available on current transition processes.Results and discussion: The perinatally HIV-infected populations in these three regions face a range of challenges including parental death and loss of family support; HIV-related stigma and socio-economic disparities; exposure to maternal injecting drug use; and late disclosure of HIV status. Behaviourally HIV-infected youth often belong to marginalized sub-groups, with particular challenges accessing services and care. Differences between and within countries in characteristics of HIV-positive youth and models of care need to be considered in comparisons of outcomes in young adulthood. The very little data published to date on transition outcomes across these three regions highlight some emerging issues around adherence, virological failure and loss to follow-up, alongside examples of programmes which have successfully supported adolescents to remain engaged with services and virologically suppressed.Conclusions: Limited data available indicate uneven outcomes in paediatric services and some shared challenges for adolescent transition including retention in care and adherence. The impact of issues specific to low prevalence, concentrated epidemic settings are poorly understood to date. Outcome data are urgently needed to guide management strategies and advocate for service provision in these regions.

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“…Women with a history of IDU had increased risk of significant fibrosis even after adjusting for HCV and HBV co-infection, possibly reflecting hepatotoxic effects of injected substances. Homemade poppy straw is the drug most commonly injected in Ukraine and in this cohort [18], usually taken with a range of other drugs [31] which may cause liver transaminase elevation. Injecting drug use has itself also been associated with thrombocytopenia [32], which would result in a higher APRI score; however, APRI has been validated in HCV infected individuals among whom IDU is common.…”

Section: Discussionmentioning

confidence: 99%

“…The Ukrainian Study of HIV-infected Childbearing Women, nested within the Ukraine European Collaborative Study (ECS), enrolled HIV-positive childbearing women with informed consent at five regional HIV/AIDS centres in Ukraine between 2007 and 2012, around 3-6 months after delivery [18]. Clinical data reported by the clinician included HIV co-infections, liver function test (LFT) and haematological test results, HIV disease status and ART.…”

Section: Methodsmentioning

confidence: 99%

HCV co-infection and markers of liver injury and fibrosis among HIV-positive childbearing women in Ukraine: results from a cohort study

et al. 2016

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BackgroundUkraine’s injecting drug use-driven HIV epidemic is among the most severe in Europe with high burden of HCV co-infection. HIV/HCV co-infected individuals are at elevated risk of HCV-related morbidity, but little is known about burden of liver disease and associated factors in the HIV-positive population in Ukraine, particularly among women.MethodsCharacteristics of 2050 HIV-positive women enrolled into the Ukrainian Study of HIV-infected Childbearing Women were described by HCV serostatus. Aspartate transaminase (AST) to platelet ratio (APRI) and FIB-4 scores were calculated and exact logistic regression models fitted to investigate factors associated with significant fibrosis (APRI >1.5) among 762 women with an APRI score available.ResultsOf 2050 HIV-positive women (median age 27.7 years, IQR 24.6-31.3), 33% were HCV co-infected (79% of those with a history of injecting drug use vs 23% without) and 17% HBsAg positive. A quarter were on antiretroviral therapy at postnatal cohort enrolment. 1% of the HIV/HCV co-infected group had ever received treatment for HCV. Overall, 24% had an alanine aminotransferase level >41 U/L and 34% an elevated AST (53% and 61% among HIV/HCV co-infected). Prevalence of significant fibrosis was 4.5%; 2.5% among 445 HIV mono-infected and 12.3% among 171 HIV/HCV co-infected women. 1.2% had a FIB-4 score >3.25 indicating advanced fibrosis. HCV RNA testing in a sub-group of 56 HIV/HCV co-infected women indicated a likely spontaneous clearance rate of 18% and predominance of HCV genotype 1, with one-third having genotype 3 infection. Factors associated with significant fibrosis were HCV co-infection (AOR 2.53 95%CI 1.03-6.23), history of injecting drug use (AOR 3.51 95%CI 1.39-8.89), WHO stage 3-4 HIV disease (AOR 3.47 95%CI 1.51-7.99 vs stage 1-2 HIV disease) and not being on combination antiretroviral therapy (AOR 3.08 95%CI 1.23-7.74), adjusted additionally for HBV co-infection, smoking and age.ConclusionsMost HIV/HCV co-infected women had elevated liver enzymes and 12% had significant fibrosis according to APRI. Risk factors for liver fibrosis in this young HIV-positive population include poorly controlled HIV and high burden of HCV. Results highlight the importance of addressing modifiable risk factors and rolling out HCV treatment to improve the health outcomes of this group.

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Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Cited by 18 publications

References 53 publications

Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine

Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine

Adolescents with HIV and transition to adult care in the Caribbean, Central America and South America, Eastern Europe and Asia and Pacific regions

HCV co-infection and markers of liver injury and fibrosis among HIV-positive childbearing women in Ukraine: results from a cohort study

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