Serum Level of Maternal Human Immunodeficiency Virus (HIV) RNA, Infant Mortality, and Vertical Transmission of HIV in Zimbabwe

Katzenstein, David; Mbizvo, Michael T.; Zijenah, Lynn S.; Gittens, Tristan; Munjoma, Marshall; Hill, David W.; Madzime, Simon; Maldonado, Yvonne

doi:10.1086/314767

Cited by 34 publications

(24 citation statements)

References 31 publications

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“…However, this association was not significant, perhaps because the event rate was relatively low. A lack of significant association of HCV load with risk of sexual transmission contrasts with the reported association of HCV load with risk of mother-infant transmission [3]. Possible explanations for this discrepancy include the relative resistance of the female genital tract against HCV infection, lower HCV RNA levels in semen than in serum, and confounding by sexual activities.…”

Section: Discussionmentioning

confidence: 78%

“…High levels of serum or plasma RNA virus load of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are each associated with increased risk of HIV and HCV transmission from mother to infant [1][2][3]. In men, HIV load is associated with risk of heterosexual transmission to their female partners [4][5][6][7], although the association of HCV load and risk of sexual transmission is uncertain.…”

mentioning

confidence: 99%

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Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

et al. 2000

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A high human immunodeficiency virus (HIV) load may increase the probability of HIV transmission by sexual contact, but the association of virus load of hepatitis C virus (HCV) with risk of HCV transmission is uncertain. HIV and HCV virus loads were examined in hemophilic men, as were risks of HIV and HCV transmission to their female partners in a hemophilia cohort in which most subjects are dually infected. A higher HIV load was associated with an increased risk of HIV transmission (odds ratio [OR], 1.31 per log10 increase in virus load). A higher HCV load was associated, although not significantly, with an increased risk of HCV transmission (OR, 1. 42 per log10). HCV load was higher among dually infected men than in those infected with HCV alone (P=.001). However, much larger studies are needed to clearly show whether HIV/HCV coinfection significantly increases the risk of HCV transmission to female partners.

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Section: Discussionmentioning

confidence: 78%

mentioning

confidence: 99%

Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

et al. 2000

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“…In fact, all of the eligibility criteria used in this study were associated with unfavorable pregnancy outcomes. An HIV-1 RNA load higher than 100,000 copies mL −1 has been shown to be strongly associated with HIV-1 mother-to-child transmission [14,15,16] . Additionally, patients with such elevated HIV-1 RNA loads have been shown to be less responsive to nelfinavir than to LPV/r [17] or TMC 114 [18] .…”

Section: Discussionmentioning

confidence: 99%

Low-Birth Weight and Pre-Term Delivery in Relation to Lopinavir/Ritonavir Use in Pregnancy

Senise¹,

Cruz²,

Palácios³

et al. 2008

American J. of Infectious Diseases

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Abstract:The toxic potential of nevirapine in pregnant women with CD4 count over 250 cells mmand the unsatisfactory efficacy of nelfinavir in patients with baseline Viral Load (VL) over 100,000 copies mL −1 has prompted the use of Lopinavir/ritonavir (LPV/r) in selected situations. This study aims to assess safety of LPV/r in pregnancy. Medical records from pregnant women receiving LPV/r were retrospectively reviewed. Charts corresponding to twin pregnancy, hypertension and having a lack of data supporting a reliable estimate of Gestational Age (GA) at delivery were excluded. Low Birth Weight (LBW) was defined as less than 2500 g. Pre-Term Delivery (PD), defined as GA at delivery less than 259 days, was estimated using date of Last Menstruation Period (LMP) and obstetrical ultrasound. A total of 64 women were analyzed. LPV/r was used in 46.9% due to virologic failure with other Protease Inhibitors (PIs). LPV/r was used for a mean of 108.8 days. Baseline median CD4+ cell count and HIV-1 RNA were 287 mm −3 and 31,100 copies mL, respectively and 345 mmand less than 400 copies mL −1 at delivery. HIV-1 was not transmitted to any newborn. LBW was observed in 13 (20.3%) and PD in 16 (25%) newborns. Time on LPV/r during pregnancy, maternal age, baseline CD4+ cell count and HIV-1 RNA, GA at initiation of LPV/r, reason for prescribing LPV/r and type of delivery were not associated with PD. Frequencies of LBW and PD were, respectively, 20.3 and 25%. Neither the magnitude nor the timing in pregnancy of LPV/r use was associated with PD.

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“…These and other results suggest frequent exposure to HIV infection in utero [46, 52]. An increase in maternal viral load by one log10 is associated with a 2-fold increase in transmission rate and a 2-fold increase in infant mortality [53]. …”

Section: Women and Hiv Infectionmentioning

confidence: 63%

HIV/AIDS in Central Africa: Pathogenesis, Immunological and Medical Issues

Sibanda

Stanczuk²,

Kasolo³

2003

Int Arch Allergy Immunol

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The estimated worldwide prevalence of human immunodeficiency virus (HIV) infections topped 52.5 million in June 2003, a mere 20 years after the aetiological agent was shown to be a sexually transmissible virus with a predilection for CD4+ T lymphocytes. More than 22 million people have died of the acquired immunodeficiency syndrome (AIDS) and the condition has in one generation become the most devastating and persistent epidemics in recorded history. More than two thirds of the world total of HIV-infected people live in Sub-Saharan Africa. In Central and Southern Africa at least 20% of the adult population is infected. As these adults die, they leave increasing numbers of orphans. Life expectancy at birth declined by 10 years per decade since the late 1980s to 50 years in the late 1990s, and in Botswana it is estimated to be as low as 33 years by 2010. The epidemic is increasing unabated and prospects for a curative or protective vaccine remain remote. The impact on HIV in Africa has been so profound that it influences political, economic, agriculture/food security, social, education, defence, science and health considerations. The medical and in particular immunology communities in Central Africa have the invidious challenge of on the one hand diagnosing the condition, monitoring its impact and contributing to treatment and management efforts. The science and clinical practice of immunology is challenged to find answers to the epidemic, perhaps including a vaccine. In this review we address the peculiarities of the HIV epidemic in Africa, its epidemiology and immunopathogenesis. We address the effect of the epidemic on individual patients, in their homes, workplaces and the knock-on effects on families and friends of the infected. Respective specialists discuss special groups (women, children) that are predominantly seen in Africa. We also discuss the impact of the epidemic on the clinical practice of medicine in general and challenges faced in the introduction of antiretroviral medicines. We also discuss options available for the diagnosis, treatment and monitoring of HIV-infected patients in this region.

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Serum Level of Maternal Human Immunodeficiency Virus (HIV) RNA, Infant Mortality, and Vertical Transmission of HIV in Zimbabwe

Cited by 34 publications

References 31 publications

Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

Virus Load and Risk of Heterosexual Transmission of Human Immunodeficiency Virus and Hepatitis C Virus by Men with Hemophilia

Low-Birth Weight and Pre-Term Delivery in Relation to Lopinavir/Ritonavir Use in Pregnancy

HIV/AIDS in Central Africa: Pathogenesis, Immunological and Medical Issues

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