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Farsimadan M, Motamedifar M. The effects of human immunodeficiency virus, human papillomavirus, herpes simplex virus-1 and -2, human herpesvirus-6 and -8, cytomegalovirus, and hepatitis B and C virus on female fertility and pregnancy. Br J Biomed Sci 2020; 78:1-11. [PMID: 32726192 DOI: 10.1080/09674845.2020.1803540] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Female infertility may be defined as a woman of reproductive age being unable to become pregnant after a year of regular unprotected sexual intercourse. Social, genetic, endocrine, physiological, and psychological factors as well as lifestyle habits (i.e., smoking and alcohol consumption), either alone or in combination with male factors, are major causes. However, approximately 15-30% of cases of female infertility remain unexplained. Numerous investigations have also indicated that microbiomes play an important role in human reproduction. All parts of the female reproductive system may be influenced by infectious and pathological agents, especially viruses, and these may interfere with reproductive function and so are risk factors for infertility, although in many cases an exact role is unclear. We present an overview of the impact of common viral infections on female reproduction, searching Medline, PubMed, Scopus, and Google scholar databases for potentially relevant studies of viruses known to have a potential effect. Human immunodeficiency virus (HIV), herpes simplex virus (HSV) and human herpesvirus (HHV) increase infertility rates whilst human papillomavirus (HPV), cytomegalovirus (CMV), and hepatitis B and C virus (HBV, HCV) infections mostly lead to higher abortion and miscarriage rates. Moreover, HPV infection is linked to increased tubal infertility, endometriosis, and pelvic inflammatory disease. HPV was the most frequently observed infection and with lower pregnancy rate and foetal death in women undergoing IVF treatments. Assisted reproductive treatment could be a safe and effective approach for HIV and HBV infected women.
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Affiliation(s)
- M Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan , Rasht, Iran
| | - M Motamedifar
- Department of Bacteriology and Virology, Shiraz Medical School, and Shiraz HIV/Aids Research Center, Institute of Health, Shiraz University of Medical Sciences , Shiraz, Iran
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Thompson J, Onyenaka C, Oduguwa E, Dongarwar D, Gendra S, Coker V, Kutse S, Blanco M, Nwangwu O, King C, Enamorado E, Bakare O, Ajewole VB, Spooner KK, Salemi JL, Aliyu MH, Salihu HM, Olaleye OA. Trends and Racial/Ethnic Disparities in the Rates of Pre-eclampsia by HIV Status in the US. J Racial Ethn Health Disparities 2020; 8:670-677. [PMID: 32754847 DOI: 10.1007/s40615-020-00826-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Preeclampsia and HIV account for a significant proportion of the global burden of disease and pose severe maternal-fetal risks. There is a dearth of literature regarding racial/ethnic disparities in preeclampsia associated with HIV/AIDS in the US. METHODS We retrospectively analyzed data from the National Inpatient Sample (NIS) database from 2002 to 2015 on a cohort of hospitalized pregnant women with or without preeclampsia and HIV. Joinpoint regression models were used to identify trends in the rates of preeclampsia among pregnant women living with or without HIV, stratified by race/ethnicity over the study period. We also assessed the association between preeclampsia and various socio-demographic factors. RESULTS We analyzed over 60 million pregnancy-related hospitalizations, of which 3665 had diagnoses of preeclampsia and HIV, corresponding to a rate of 0.61 per 10,000. There was an increasing trend in the diagnosis of preeclampsia among hospitalized, pregnant women without HIV across each racial/ethnic category. The highest prevalence of preeclampsia was among non-Hispanic (NH) Blacks, regardless of HIV status. CONCLUSION The increase in rates of pre-eclampsia between 2002 and 2015 was mostly noted among pregnant women without HIV. Regardless of HIV status, NH-Blacks experienced the highest discharge prevalence of preeclampsia.
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Affiliation(s)
- Jamalena Thompson
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Collins Onyenaka
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Emmanuella Oduguwa
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA.
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA
| | - Sumaya Gendra
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Vidella Coker
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Seun Kutse
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Mayra Blanco
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Onyinye Nwangwu
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Charlee King
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Elza Enamorado
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Oluwatoyin Bakare
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Veronica B Ajewole
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
| | - Kiara K Spooner
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jason L Salemi
- College of Public Health, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Muktar H Aliyu
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77098, USA.,Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Omonike A Olaleye
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX, USA
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Abdi F, Alimoradi Z, Alidost F. Pregnancy outcomes and effects of antiretroviral drugs in HIV-positive pregnant women: a systematic review. Future Virol 2019. [DOI: 10.2217/fvl-2018-0213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Despite the clear morbidity, mortality and vertical transmission rates in women infected with HIV, there is still controversy surrounding the relationship between maternal infection and adverse neonatal outcomes. Antiretroviral therapy during pregnancy is considered the main and most effective method for reducing the vertical transmission of infection. However, there is no consensus over potential associations between antiretroviral therapy and adverse pregnancy outcomes. This systematic review focuses on the effects of antiretroviral drugs on pregnancy outcomes in HIV-positive women. Methods: After searching MEDLINE, the Cochrane Database of Systematic Reviews, the ISI Web of Sciences and EMBASE, 570 potentially eligible papers were identified. Only 32 papers were selected based on the inclusion criteria. Results: The most prevalent adverse pregnancy outcomes were low birth weight, preterm birth and stillbirth. Conclusion: Considering the higher prevalence of adverse pregnancy outcomes in HIV-infected women, HIV screening methods should be administered in all pregnant women. Appropriate treatment modalities should also be selected to minimize adverse pregnancy outcomes.
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Affiliation(s)
- Fatemeh Abdi
- Student Research Committee, Nursing & Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zainab Alimoradi
- Department of Midwifery, Nursing & Midwifery Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farzane Alidost
- Department of Reproductive Health, Nursing & Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dos Reis HLB, Araujo KDS, Ribeiro LP, Da Rocha DR, Rosato DP, Passos MRL, Merçon De Vargas PR. Preterm birth and fetal growth restriction in HIV-infected Brazilian pregnant women. Rev Inst Med Trop Sao Paulo 2016; 57:111-20. [PMID: 25923889 PMCID: PMC4435008 DOI: 10.1590/s0036-46652015000200003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 07/24/2014] [Indexed: 01/06/2023] Open
Abstract
Introduction: Maternal HIV infection and related co-morbidities may have two outstanding
consequences to fetal health: mother-to-child transmission (MTCT) and adverse
perinatal outcomes. After Brazilian success in reducing MTCT, the attention must
now be diverted to the potentially increased risk for preterm birth (PTB) and
intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users,
publicly assisted, HIV-infected women and to verify its relation to the HIV
infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary
public university hospital in the city of Vitória, state of Espírito Santo,
Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were
selected for study, with ultrasound validated gestational age (GA) and data on
birth dimensions: fetal weight (FW), birth length (BL), head and abdominal
circumferences (HC, AC). The data were extracted from clinical and pathological
records, and the outcomes summarized as proportions of preterm birth (PTB, < 37
weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and
large (LGA) for GA, defined as having a value below, between or beyond the ±1.28
z/GA score, the usual clinical cut-off to demarcate the 10th and 90th
percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%,
13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were:
PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL:
6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL
attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were
preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA
cases. A concomitant presence of, at least, two SGA dimensions in the same fetus
was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local
and Brazilian prevalence and a trend was observed for higher proportions of SGA
fetal dimensions than the expected population distribution in this small casuistry
of newborn from the HIV-infected, low income, antiretroviral users, and publicly
assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal
dimensions was also observed in infants born to mothers with AIDS compared to
HIV-infected mothers without AIDS.
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Affiliation(s)
| | | | | | | | | | - Mauro Romero Leal Passos
- Materno-fetal Health Postgraduate Course, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
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Macdonald EM, Ng R, Bayoumi AM, Raboud J, Brophy J, Masinde KI, Tharao WE, Yudin MH, Loutfy MR, Glazier RH, Antoniou T. Adverse Neonatal Outcomes Among Women Living With HIV: A Population-Based Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:302-309. [PMID: 26001682 DOI: 10.1016/s1701-2163(15)30279-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND There have been few population-based studies describing the risk of adverse neonatal outcomes among women living with HIV in Canada. Accordingly, we compared the risk of preterm birth (PTB), low birth weight (LBW) and small for gestational age births among Ontario women aged 18 to 49 years living with and without HIV infection. METHODS We conducted a population-based study using Ontario health administrative data. Generalized estimating equations with a logit link function were used to derive adjusted odds ratios (aORs) and 95% confidence intervals for the association of HIV infection with adverse neonatal outcomes. RESULTS Between 2002-2003 and 2010-2011, a total of 1 113 874 singleton live births were available for analysis, of which 615 (0.06%) were to women living with HIV. The proportion of singleton births that were SGA (14.6% vs. 10.3%; P < 0.001), PTB (14.6% vs. 6.3%; P < 0.001), and LBW (12.5% vs. 4.6%; P < 0.001) were higher among women living with HIV than among women without HIV. Following multivariable adjustment, the risks of PTB (aOR 1.76; 95% CI 1.38 to 2.24), SGA (aOR 1.43; 95% CI 1.12 to 1.81), and LBW (aOR 1.90; 95% CI 1.47 to 2.45) were higher for women living with HIV than for women without HIV. CONCLUSION Women with HIV are at higher risk of adverse neonatal outcomes than HIV-negative women. Further research is required to develop preconception and prenatal interventions that could reduce the excess burden of poor pregnancy outcomes among women living with HIV.
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Affiliation(s)
| | - Ryan Ng
- Institute for Clinical Evaluative Sciences, Toronto ON
| | - Ahmed M Bayoumi
- Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Department of Medicine, University of Toronto, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON
| | - Janet Raboud
- Institute for Clinical Evaluative Sciences, Toronto ON; Toronto General Research institute, University Health Network, Toronto ON; Dalla Lana School of Public Health, University of Toronto, Toronto ON
| | - Jason Brophy
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa ON
| | | | - Wangari E Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto ON
| | - Mark H Yudin
- Li Ka Shing Knowledge institute, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON; Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto ON
| | - Mona R Loutfy
- Institute for Clinical Evaluative Sciences, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Department of Medicine, University of Toronto, Toronto ON; Women's College Research institute, Women's College Hospital, Toronto ON
| | - Richard H Glazier
- Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto ON; Centre for Research on inner City Health, St. Michael's Hospital, Toronto ON; Dalla Lana School of Public Health, University of Toronto, Toronto ON; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto ON
| | - Tony Antoniou
- Institute for Clinical Evaluative Sciences, Toronto ON; Li Ka Shing Knowledge institute, Toronto ON; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON
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Kabami J, Turyakira E, Biraro S, Bajunirwe F. Increasing incidence of pregnancy among women receiving HIV care and treatment at a large urban facility in western Uganda. Reprod Health 2014; 11:81. [PMID: 25480367 PMCID: PMC4364564 DOI: 10.1186/1742-4755-11-81] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/26/2014] [Indexed: 11/19/2022] Open
Abstract
Background Antiretroviral treatment restores physical functioning and may have an impact on fertility desires. Counseling is given to HIV positive women to create awareness and to provide information on pregnancy and delivery. The purpose of this study was to determine the incidence of pregnancy and factors that predict pregnancy among women of reproductive age receiving HIV care and treatment at a large urban center in western Uganda. Methods We conducted a retrospective cohort study using routinely collected data at the Immune Suppression (ISS) Clinic of Mbarara Regional Referral Hospital located in Mbarara District, western Uganda collected between January 2006 and June 2010. Women aged 15 to 50 years were eligible for analysis. The primary outcome was incidence of pregnancy calculated as number of pregnancies per 1000 person years (PY). Data was analyzed by calendar year and year of enrolment and used survival analysis to determine the predictors of pregnancy. Results A total of 3144 women were included with a median follow up of 12.5 months. The overall incidence rate was 90.7 pregnancies per 1000 person years. Incidence increased from 29.8 pregnancies per 1000 PY in 2006 to 122 pregnancies per 1000 PY in 2010 (p < 0.001). Significant predictors for pregnancy were younger age (HR 10.96 95% CI 3.22-37.2), married (HR 2.09 95% CI 1.69-2.64) and single (HR 1.95 95% CI 1.34-2.84) compared to widowed or separated, primary education (HR 1.65 95% CI 1.02-2.66), not knowing the HIV status of the spouse (HR 1.46, 95%CI 1.13-1.93) compared to knowing. The use of family planning (HR 0.23 95% CI 0.18- 0.30) and an increase in CD4 count between baseline and most recent count were protective against pregnancy. ART use was not a significant predictor. Conclusion Incidence of pregnancy among women receiving routine HIV care and treatment has increased and is almost comparable to that in the general population. Thus routine HIV care should integrate reproductive health needs for these women. Electronic supplementary material The online version of this article (doi:10.1186/1742-4755-11-81) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, P,O, BOX 1410, Mbarara, Uganda.
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Feyissa TR, Melka AS. Demand for modern family planning among married women living with HIV in western Ethiopia. PLoS One 2014; 9:e113008. [PMID: 25390620 PMCID: PMC4229307 DOI: 10.1371/journal.pone.0113008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/22/2014] [Indexed: 11/18/2022] Open
Abstract
Introduction People living with HIV (PLHIV) have diverse family planning (FP) needs. Little is reported on FP needs among women living with HIV in Ethiopia. Thus, the objective of the study was to assess the demand for modern FP among married women living with HIV in western Ethiopia. Methods A facility-based cross-sectional survey was conducted on 401 married women living with HIV selected from Nekemte Referral Hospital and Health Center, Nekemte, Oromia, Ethiopia. Convenience sampling of every other eligible patient was used to recruit respondents. Data were collected using a pretested, structured questionnaire. We first calculated frequency and percentage of unmet need, met need and total demand by each explanatory variable, and performed chi-squared testing to assess for differences in groups. We then fitted logistic regression models to identify correlates of unmet need for modern FP at 95% CL. Results The proportion of respondents with met need for modern FP among married women living with HIV was 61.6% (30.7% for spacing and 30.9% for limiting). Demand for family planning was reported in 77.0% (38.2% for spacing and 38.8% for limiting), making unmet need for modern FP prevalent in 15.4% (7.5% for spacing and 7.9% for limiting). Whereas age 25–34 years [adjusted odds ratio (AOR) (95% confidence interval (CI)) = .397 (.204–.771)] was protective against unmet need for modern FP, not having knowledge of MTCT [AOR (95% CI) = 2.531 (1.689–9.290)] and not discussing FP with a partner [AOR (95% CI) = 3.616(1.869–6.996)] were associated with increased odds of unmet need for modern FP. Conclusions There is high unmet need for modern FP in HIV-positive married women in western Ethiopia. Health care providers and program managers at a local and international level should work to satisfy the unmet need for modern family planning.
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Affiliation(s)
- Tesfaye Regassa Feyissa
- College of Medical and Health sciences, Wollega University, Nekemte, Oromia, Ethiopia
- * E-mail:
| | - Alemu Sufa Melka
- College of Medical and Health sciences, Wollega University, Nekemte, Oromia, Ethiopia
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Darak S, Darak T, Kulkarni S, Kulkarni V, Parchure R, Hutter I, Janssen F. Effect of highly active antiretroviral treatment (HAART) during pregnancy on pregnancy outcomes: experiences from a PMTCT program in western India. AIDS Patient Care STDS 2013; 27:163-70. [PMID: 23477457 DOI: 10.1089/apc.2012.0401] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous research regarding the effect of highly active antiretroviral treatment (HAART) on pregnancy outcomes shows conflicting results and is predominantly situated in developed countries. Recently, HAART is rapidly being scaled up in developing countries for prevention of mother-to-child transmission (PMTCT). This study compared adverse pregnancy outcomes among HIV infected women (N=516) who received either HAART (N=192)--mostly without protease inhibitor--or antepartum azidothymidine (AZT) with intrapartum nevirapine (N=324) from January 2008 to March 2012 through a PMTCT program in western India. We analyzed the effect of HAART on preterm births, low birth weight, and all adverse pregnancy outcomes combined using univariate and multivariate logistic regression models. Women on HAART had 48% adverse pregnancy outcomes, 25% preterm births, and 34% low birth weight children compared to respectively 32%, 13%, and 22% among women on AZT. Women receiving HAART were more likely to have adverse pregnancy outcomes and preterm births compared to women receiving AZT. Preconception HAART was significantly related to low birth weight children. This study demonstrated increased risk of adverse pregnancy outcomes with protease inhibitor excluded HAART. Prospective studies assessing the impact of HAART on MTCT as measured in terms of HIV-free survival among children are needed.
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Affiliation(s)
- Shrinivas Darak
- Faculty of Spatial Sciences, Population Research Centre, University of Groningen, the Netherlands
- PRAYAS Health Group, Pune, India
| | | | | | | | | | - Inge Hutter
- Faculty of Spatial Sciences, Population Research Centre, University of Groningen, the Netherlands
| | - Fanny Janssen
- Faculty of Spatial Sciences, Population Research Centre, University of Groningen, the Netherlands
- Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, the Netherlands
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Savasi V, Mandia L, Laoreti A, Cetin I. Reproductive assistance in HIV serodiscordant couples. Hum Reprod Update 2012; 19:136-50. [PMID: 23146867 DOI: 10.1093/humupd/dms046] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Three quarters of individuals infected with human immunodeficiency virus (HIV) are in their reproductive years and may consider pregnancy planning. Techniques have been developed which can minimize the risk of HIV transmission in these couples, and the current literature on this topic is reviewed here. METHODS We reviewed the literature for the following topics: risk of HIV transmission, effects of HIV infection on fertility, reproductive assistance in industrialized and low-income countries, pre-exposure chemoprophylaxis (PrEP) and timed intercourse in HIV-discordant couples for both male and female positivity. Relevant publications were identified through searches of the EMBASE Medline and PubMed databases, the Google-indexed scientific literature and periodic specialized magazines from the on-line Library Service of the University of Milan, Italy. RESULTS In serodiscordant couples in which the man is positive, the primary method used to prevent HIV transmission is 'sperm washing', followed by IUI or IVF. Data show that sperm washing in HIV-positive men has not produced seroconversion in women or their offspring; however, the evidence is limited. Recently, increasing evidence describing PrEP for HIV prevention has been published and PrEP could be an alternative to ART for fertile couples. Usually HIV-infected women undergo self-insemination around the time of ovulation. Few studies have been published on IVF outcome in HIV-infected women. CONCLUSIONS Assisted reproduction programmes should be integrated into global public health services against HIV. For HIV serodiscordant couples with infected men, sperm washing should be the first choice. However, timed intercourse and PrEP for HIV prevention has been reported. Recent data highlight the possible impairment of fertility in HIV-infected women. Efforts to design a multicentric study should be strengthened.
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Affiliation(s)
- V Savasi
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences, Hospital L. Sacco, University of Milan, Via G. B. Grassi, 74, 20157 Milan, Italy.
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Finocchario-Kessler S, Mabachi N, Dariotis JK, Anderson J, Goggin K, Sweat M. "We weren't using condoms because we were trying to conceive": the need for reproductive counseling for HIV-positive women in clinical care. AIDS Patient Care STDS 2012; 26:700-7. [PMID: 23025705 DOI: 10.1089/apc.2012.0232] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although a significant number of HIV-positive women intend to have children in the future, few work with providers to safely plan pregnancy. We conducted 20 semistructured in depth interviews with HIV-positive adolescent and adult women receiving HIV clinical care in an urban setting. Participants were purposively sampled to include diversity in age and childbearing plans. Interview transcripts were analyzed and coded independently by two study team members before reaching consensus on emergent themes. Among this sample of HIV-positive women (mean age=27.9, 95% African American, 50% on antiretroviral therapy [ART], 65% want a biological child), only 25% reported discussing their childbearing goals with their HIV provider. Women actively trying to conceive recognized the risk to themselves and their partner, but had not talked with their provider about safer conception strategies. Data regarding provider communication about childbearing were organized by the following emergent themes: (1) confusion and concern on how to conceive safely, (2) provider characteristics or dynamics that influenced communication, and (3) provider guidance offered regarding childbearing. Even in this unique study setting in which referrals for preconception counseling are possible, women were unaware of this specialized service. Provider initiated reproductive counseling is needed to strategically avoid or plan pregnancy and reduce risk of transmission to partners and infants rather than leaving it to chance, which can have major health implications.
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Affiliation(s)
- Sarah Finocchario-Kessler
- Kansas University Medical Center, Family Medicine, Kansas City, Kansas
- University of Missouri-Kansas City, HIV Research Group, Kansas City, Missouri
| | - Natabhona Mabachi
- Kansas University Medical Center, Family Medicine, Kansas City, Kansas
| | - Jacinda K. Dariotis
- Johns Hopkins Bloomberg School of Public Health, Population, Family and Reproductive Health, Baltimore, Maryland
| | - Jean Anderson
- The Johns Hopkins School of Medicine, Obstetrics & Gynecology, Baltimore, Maryland
| | - Kathy Goggin
- University of Missouri-Kansas City, HIV Research Group, Kansas City, Missouri
| | - Michael Sweat
- Medical University of South Carolina, Psychiatry & Behavioral Sciences, Charleston, South Carolina
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Floridia M, Ravizza M, Guaraldi G, Pinnetti C, Martinelli P, Tamburrini, on behalf of The Italia E. Use of specific antiretroviral regimens among HIV-infected women in Italy at time of conception: 2001-2011. AIDS Patient Care STDS 2012; 26:439-43. [PMID: 22663250 DOI: 10.1089/apc.2012.0116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Marco Floridia
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Ravizza
- S. Paolo Hospital, Department of Obstetrics and Ginaecology, Milan, Italy
| | - Giovanni Guaraldi
- Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Carmela Pinnetti
- Department of Infectious Diseases, Catholic University, and National Institute for Infectious Diseases “L. Spallanzani,” Rome, Italy
| | - Pasquale Martinelli
- Department of Obstetrics and Gynaecology, University Federico II of Naples, Naples, Italy
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