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Li R, Han L, Xiong W, Wang W, Fan C, Li M, Liu X, Ling L. The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: a population-based study in southern China. BMC Public Health 2023; 23:351. [PMID: 36797787 PMCID: PMC9933307 DOI: 10.1186/s12889-023-15238-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse's migrant status on the TORCH epidemic among women of childbearing age. METHODS Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15-49 years old) in Guangdong Province of China (2014-2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors. RESULTS Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88-0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77-1.99), past CMV infection (aOR: 1.26, 1.25-1.28) and RV infection in natural ways (aOR: 1.05, 1.04-1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85-0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05-1.27) and RV infection (aOR: 1.33, 1.31-1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection. CONCLUSION This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse's migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.
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Affiliation(s)
- Rui Li
- grid.12981.330000 0001 2360 039XFaculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080 Guangzhou, Guangdong China
| | - Lu Han
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), 510600 Guangzhou, China
| | - Wenxue Xiong
- grid.12981.330000 0001 2360 039XFaculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080 Guangzhou, Guangdong China
| | - Wenjuan Wang
- grid.12981.330000 0001 2360 039XFaculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080 Guangzhou, Guangdong China
| | - Chaonan Fan
- grid.12981.330000 0001 2360 039XFaculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080 Guangzhou, Guangdong China
| | - Mingzhen Li
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), 510600 Guangzhou, China
| | - Xiaohua Liu
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), 510600, Guangzhou, China.
| | - Li Ling
- Faculty of Medical Statistic, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China. .,Clinical research design division, Clinical research center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
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The Prevalence of HIV Infection in Minority Indigenous Populations of the South-East Asia and Western Pacific Regions: A Systematic Review and Meta-analysis. AIDS Behav 2022; 27:2226-2242. [PMID: 36543946 PMCID: PMC9771782 DOI: 10.1007/s10461-022-03954-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
A random effects meta-analysis was used to estimate the pooled prevalence of HIV infection within minority indigenous populations of the South-East Asia (SEAR) and Western Pacific Regions (WPR). Sub-group analyses were conducted, and the sources of heterogeneity explored through meta-regression. The majority of studies were undertaken in high HIV risk subpopulations. There was a paucity of data for many countries with data from China representing 70% of the comparative studies. Within minority indigenous populations the pooled prevalence of HIV infection was 13.7% (95% CI 8.9, 19) and 8.4% (95% CI 6.3, 10.7) among other populations. The prevalence differential between populations was significant in the WPR (adjusted odds ratio 1.1, 95% CI 1.0, 1.2). Across both regions, in contrast to other populations, minority indigenous did not experience any significant reduction in HIV prevalence over the years of data collection. There was large heterogeneity in the prevalence of HIV across studies.
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Pompeu HHFA, Moraes LPD, Santos CCG, Shibata HY, Rocha JECD, Pereira AA, Barros CDSD, Monteiro CPS. Prevalence of the Human Immunodeficiency Virus and associated factors in pregnant women in the state of Pará. Rev Bras Enferm 2022; 75:e20210171. [PMID: 35766751 DOI: 10.1590/0034-7167-2021-0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/16/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the prevalence of the Human Immunodeficiency Virus and the associated factors in pregnant women in the state of Pará. METHODS retrospective, analytical, quantitative study with a sample of 332 medical records of HIV-positive pregnant women hospitalized at the Referral Maternity Hospital in the state of Pará between 2010 and 2019. Bivariate and multivariate statistical analysis were performed with the variables collected. RESULTS the average prevalence in the period was 2.39% and the Metropolitan Region concentrated 66.87% of cases. There was a strong relationship between the number of antenatal consultations and lack of knowledge of serological status (p value equal to 0.01E-17) variables, and a correlation between the education and number of antenatal consultations variables. CONCLUSIONS the increase in the infection rate during the study period revealed the need to intensify health actions, early diagnosis and strategies to improve adherence to antiretroviral treatment for maternal viral suppression and reduction of the risk of vertical transmission, contributing to improve public policies.
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Qu S, Wang A, Wang X, Yang Y, Pan X, Zhang T. Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e29906. [PMID: 35380543 PMCID: PMC9019641 DOI: 10.2196/29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Liangshan prefecture of Sichuan province was an impoverished mountainous area in China, where the annual number of HIV-positive pregnant women accounted for approximately 10% of China’s total population in the decades before 2020. In general, pregnant women living here are likely to be physically and mentally different from those in other places. Objective This study aims to explore the health-related quality of life (HRQoL) of pregnant women living with HIV in an impoverished area. Methods From December 2018 to January 2019, HIV-positive and HIV-negative parturients within 18 months after delivery were recruited in Liangshan Prefecture, Sichuan Province. Questionnaires were designed to collect their demographic data, while the EuroQol 5-Dimension, 3-Level questionnaire was used to measure their HRQoL when they were in the second trimester from 4 to 6 months of pregnancy, and their quantitative health scores were converted to corresponding healthy utility values by using the Chinese Utility Value Integral System (time trade-off coefficient). Results A total of 250 pregnant women (133 HIV-positive and 117 HIV-negative) were enrolled in the study. Among them, 55 (41.35%) and 75 (64.10%) of HIV-positive and HIV-negative pregnant women self-reported full health (healthy state 11111), respectively. The median health utility value of the 250 pregnant women was 0.961 (IQR –0.046 to 0.961), and those of the HIV-positive and HIV-negative pregnant women were 0.875 (0.424-0.961) and 0.961 (IQR –0.046 to 0.961), respectively. We observed a significant difference only in the dimension of anxiety or depression between the two groups (P=.002) and no significant difference in the distribution of health utility indices between the two groups in terms of maternal age, education level, occupation, annual household income, prenatal care visits, family size, and medical insurance category. Multivariate ordinal logistic regression analysis showed that age (odds ratio [OR] 0.62, P<.05) and prenatal care visit (OR 0.29, P<.01) were independent risk factors for health status. Conclusions Most pregnant women self-reported satisfactory HRQoL in this impoverished mountainous area. HIV-negative pregnant women had an edge over HIV-positive pregnant women, and there were significant differences in anxiety or depression dimensions between the two groups.
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Affiliation(s)
- Shuiling Qu
- Chinese Center for Disease Control and Prevention, Beijing, China.,National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyan Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yehuan Yang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoping Pan
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tong Zhang
- Capital Institute of Pediatrics, Beijing, China
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Genetu K, Abere K, Tachbele E. Magnitudes and Correlates of Human Immunodeficiency Virus, Hepatitis B Virus, and Syphilis among Pregnant Mothers Attending Antenatal Care in Addis Ababa, Ethiopia. Infect Dis Obstet Gynecol 2022; 2022:6156613. [PMID: 35221648 PMCID: PMC8865988 DOI: 10.1155/2022/6156613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis are major sexually transmitted infections (STIs) among the general population in Ethiopia, which in turn result in a wide range of adverse pregnancy outcomes. Hence, it is important to determine the seroprevalence and risk factors of HIV, HBV, and syphilis infection among pregnant mothers attending antenatal care in Addis Ababa, Ethiopia. METHOD A cross-sectional study was conducted among 286 pregnant women from February 1, 2021, to March 30, 2021, in four selected public hospitals in Addis Ababa. Sociodemographic, risky sociocultural, behavioral, and hospital-related factors were collected using an interview-administered questionnaire. Detection of anti-HIV antibodies, hepatitis B surface antigen (HBsAg), and rapid plasma reagin (RPR) for syphilis was conducted. A binary logistic regression analysis was used to determine predictors of STIs using SPSS version 25. RESULT A total of 281 pregnant mothers with a mean age of 27.5 (SD 4.6) completed the study. Among the participants, the seroprevalence rates of HIV, HBV, and syphilis were 15 (5.3%), 9 (3.2%), and 5 (1.8%), respectively. Twenty six (9.3%) of the participants tested positive for any one of the STIs, and 3 (1.1%) of the women had HIV and syphilis coinfections. History of multiple sexual partners (AOR 3.42, 95% CI: 1.6-11.63) and STIs (AOR 3.7; 95% CI: 1.70-13.45) were significantly associated with HIV infection. Likewise, history of abortion (AOR 7.65, 95% CI: 1.17-49.74), tattooing (AOR 9.72, 95% CI: 1.41-66.73), and rape (AOR 9.72, 95% CI: 1.41-66.73) were significantly associated with hepatitis B virus infection. Husband history of multiple sexual partners (AOR 20.9, 95% CI: 1.8-241.8) was significantly associated with syphilis infection. The educational level of participants, history of tattooing (AOR 6.24, 95% CI: 1.79-21.7), and history of multiple sexual partners (AOR 5.15, 95% CI: 1.68-15.7) were independent predictors of infection with any one of the STIs. CONCLUSION There is still a high burden of HIV, HBV, and syphilis among pregnant mothers in Ethiopia. History of multiple sexual partners, abortion, rape, and tattooing was a significant predictor of STIs.
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Affiliation(s)
- Kassa Genetu
- College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Kerebih Abere
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Erdaw Tachbele
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Chen L, Liu CH, Kang S, Du L, Ma F, Li C, Bai L, Li H, Tang H. Determinants of suboptimal immune recovery among a Chinese Yi ethnicity population with sustained HIV suppression. BMC Infect Dis 2022; 22:137. [PMID: 35135485 PMCID: PMC8827152 DOI: 10.1186/s12879-022-07113-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/28/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Despite sustained viral suppression with effective antiretroviral therapy (ART), HIV-infected patients with suboptimal immune recovery are still at high risk of both non-AIDS-related and AIDS-related events. The aim of this study was to investigate determinants potentially associated with suboptimal CD4 + T cell count recovery during free ART with sustained viral suppression among an HIV-infected Yi ethnicity population in Liangshan Prefecture, an area in China with high HIV prevalence. METHODS This retrospective study included HIV-infected Yi adults (≥ 18 years and baseline CD4 + T cell count less than 500 cells/μL) for whom ART supported by National Free Antiretroviral Treatment Program was initiated between January 2015 and December 2018 in Zhaojue County, Liangshan Prefecture. Virological suppression (viral load < 50 copies/mL) was achieved within 12 months after ART initiation, and sustained virological suppression was maintained. Multivariate log-binomial regression analysis was used to assess determinants of suboptimal immune recovery. RESULTS There were 140 female and 137 male patients in this study, with a mean age of 36.57 ± 7.63 years. Most of the Yi patients were infected through IDU (48.7%) or heterosexual contact (49.8%), and the anti-HCV antibody prevalence was high (43.7%, 121/277). Of the 277 patients with a mean ART duration of 3.77 ± 1.21 years, complete immune recovery occurred in only 32.9%. The baseline CD4 + T cell count in patients with suboptimal and intermediate immune recovery was 248.64 ± 108.10 and 288.59 ± 108.86 cells/μL, respectively, which was much lower than the baseline 320.02 ± 123.65 cells/μL in patients who achieved complete immune recovery (p < 0.001). Multivariable analysis demonstrated that low pre-ART CD4 + cell count and coinfection with HCV were associated with immune recovery of the HIV patients. CONCLUSIONS Our study suggests that for HIV-infected Yi patients in Liangshan Prefecture, prompt ART initiation after diagnosis of HIV infection should be applied, and curative HCV treatment should be given to patients with HCV/HIV coinfection to improve the immunological effectiveness of ART. Trial registration None.
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Affiliation(s)
- Liyu Chen
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
- Center of Antiretroviral Treatment, People's Hospital of Zhaojue County, 616150, Liangshan, Yi Autonomous Prefecture, China
| | - Chang-Hai Liu
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Shuang Kang
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Lingyao Du
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Fanghua Ma
- Center of Antiretroviral Treatment, People's Hospital of Zhaojue County, 616150, Liangshan, Yi Autonomous Prefecture, China
| | - Changmin Li
- Center of Antiretroviral Treatment, People's Hospital of Zhaojue County, 616150, Liangshan, Yi Autonomous Prefecture, China
| | - Lang Bai
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Li
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
- Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
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Analysis of death causes of residents in poverty-stricken Areas in 2020: take Liangshan Yi Autonomous Prefecture in China as an example. BMC Public Health 2022; 22:89. [PMID: 35027039 PMCID: PMC8758188 DOI: 10.1186/s12889-022-12504-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Continuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas. Methods Liangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected. Results In 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women’s. The former severely impoverished counties’ age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years). Conclusions Taking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12504-6.
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Pompeu HHFA, Moraes LPD, Santos CCG, Shibata HY, Rocha JECD, Pereira AA, Barros CDSD, Monteiro CPS. Prevalência do Vírus da Imunodeficiência Humana e fatores associados em gestantes no estado do Pará. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0171pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: analisar a prevalência do Vírus da Imunodeficiência Humana e os fatores associados em gestantes no estado do Pará. Métodos: estudo analítico, quantitativo e retrospectivo com a amostra de 332 prontuários de gestantes HIV positivas internadas na Maternidade de Referência do estado do Pará, no período de 2010 a 2019. Com as variáveis coletadas, procedeu-se a análise estatística bivariada e multivariada. Resultados: a média de prevalência no período foi de 2,39% e a Região Metropolitana concentrou 66,87% dos casos. Houve forte relação entre as variáveis número de consultas pré-natais e desconhecimento do status sorológico (p valor igual a 0,01E-17) e correlação entre as variáveis escolaridade com o número de consultas pré-natais. Conclusões: o aumento da taxa de infecção no período estudado revelou a necessidade de intensificar as ações de saúde, o diagnóstico precoce e as estratégias para a melhoria da adesão ao tratamento antirretroviral para supressão viral materna e redução do risco de transmissão vertical, contribuindo para aprimorar as políticas públicas.
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Wang X, Yin Y, Wang H, Chen H. Ability to Cope by Family Caregivers of People Living With HIV in the Yi Population in Liangshan Prefecture: A Cross-sectional Study. J Assoc Nurses AIDS Care 2021; 32:569-577. [PMID: 32809986 DOI: 10.1097/jnc.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Informal caregivers' abilities to provide care for people living with HIV plays an essential role in improving health outcomes. Little is known about caregivers in the Yi population. A cross-sectional study was conducted, and 216 participants completed the Chinese version of the Caregiver Task Inventory (CTI-C). The total mean CTI-C score was 17.46 (SD = 7.70), which showed a low level of caring ability. Regression analysis indicated that caregiving willingness and caring time were significantly positively associated with CTI-C scores. Knowledge regarding HIV was negatively associated with CTI-C scores. There is an urgent need to increase the level of HIV-related knowledge in the rural regions of Liangshan Prefecture. Education contributes to improved knowledge. Therefore, educational campaigns should be implemented to improve this situation. The local government should plan policies to improve educational levels and develop targeted knowledge-improving programs based on cultural background.
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Affiliation(s)
- Xia Wang
- Xia Wang, BN, RN, Yao Yin, BN, RN, and Huan Wang, BN, RN, are graduate students, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China. Hong Chen, PhD, RN, is a Professor, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Liu L, Dong A, Liao L, Feng Y, Shao Y, Liang S, Ruan Y, Xing H. Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China. Curr HIV Res 2021; 17:441-451. [PMID: 31778107 PMCID: PMC7497539 DOI: 10.2174/1570162x17666191128101426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 11/22/2022]
Abstract
Background: Pretreatment drug resistance (PDR) poses an increasing threat to the success of antiretroviral treatment (ART) programs in China. We aimed to conduct a survey of PDR among HIV patients in an area in Southwest China with extensive drug trafficking. Methods: Consecutive cross-sectional surveys were conducted in Liangshan Prefecture of Sichuan Province from 2009 to 2018 based on the WHO-recommended method. PDR was identified by testing pol region sequences with the Stanford HIVdb algorithm (version 7.0). PDR prevalence and related factors were assessed by multivariable logistic regression. The transmission of HIV drug resistance was analyzed using a genetic transmission network. Results: HIV-1 pol genes from 1889 patients were successfully amplified. The distribution of HIV-1 genotypes was as follows: CRF07_BC (94.0%), CRF08_BC (2.3%), CRF01_AE (2.0%) and others (1.4%). Of the participants, 6.9% (95% CI: 4.1-8.1%) had pretreatment resistance to 12 antiretroviral drugs recommended by the WHO, and nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitors (PI) resistance were identified among 1.4% (95% CI: 0.7-3.4%), 5.8% (95% CI: 1.2-8.7%) and 0.4% (95% CI: 0.1-3.0%) of the patients, respectively. In the multivariate logistic model, the prevalence of PDR was 1.52-fold higher among intravenous drug users (IDUs) than among patients infected by heterosexual transmission (95% CI: 1.07-2.38; P=0.049), and the prevalence of PDR among patients diagnosed from 2017-2018 was 2.03-fold higher than that among patients diagnosed from 2009-2016 (95% CI: 1.18-5.76; P=0.018). A total of 26 clusters containing PDR and a rapidly growing drug resistance-related cluster containing the E138Q and V179D mutations were identified by genetic transmission network analysis. Conclusion: The results show a moderate overall level of PDR prevalence and rapidly growing drug resistance over time. Preventive intervention should be focused on controlling the HIV epidemic among drug users, and surveillance is urgently needed to monitor the trend of PDR.
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Affiliation(s)
- Lei Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Aobo Dong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Lingjie Liao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Yi Feng
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Yiming Shao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Shu Liang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Hui Xing
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
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11
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Sebastião CS, Neto Z, Jandondo D, Mirandela M, Morais J, Brito M. HIV, hepatitis B virus, hepatitis C virus, and syphilis among pregnant women attending antenatal care in Luanda, Angola: Seroprevalence and risk factors. J Med Virol 2020; 92:3265-3270. [PMID: 32515502 DOI: 10.1002/jmv.26148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/20/2020] [Accepted: 06/07/2020] [Indexed: 01/17/2023]
Abstract
Infectious diseases during pregnancy remain a public health concern, especially in a resource-limited setting. The study aimed to determine the seroprevalence and determinants of HIV and co-infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among pregnant women attending antenatal care in Luanda, the capital city of Angola. A cross-sectional study was conducted with 1612 pregnant women screened for HIV during antenatal care. HIV-reactive were also screened for the HBV, HCV, and syphilis using immunoassay kits. A logistic regression model, adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. The overall seroprevalence of HIV was 2.6%. About 13% of HIV-positive pregnant women were coinfected. From which, 7.5% were reactive to HBV and 5% to syphilis. There was no reactivity to HCV. Pregnant women younger aged than 25 years were significantly protected from HIV-infection (AOR, 0.43 [95% CI, 0.20-0.91], P = .026). The co-infection was 1.3 times (AOR, 0.04-41.0) in younger aged than 25 years, 7.0 times (AOR, 0.50-99.2) to residents in urbanized areas, and 1.4 times (AOR, 0.10-20.9) in pregnant women with a high educational level. In conclusion, infectious diseases are a public health burden among pregnant women in Luanda. However, include an integrated antenatal screening mainly in urbanized areas is crucial to reduce the spread of infectious diseases in different communities of Angola.
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Affiliation(s)
- Cruz S Sebastião
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Instituto Superior de Ciências da Saúde, Universidade Agostinho Neto, Luanda, Angola
- Laboratory of Immunobiology and Pathogenesis of CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Zoraima Neto
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Domingos Jandondo
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Marinela Mirandela
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Joana Morais
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Faculdade de Medicina, Universidade Agostinho Neto, Luanda, Angola
| | - Miguel Brito
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
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12
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Xiao C, Jike C, Liu D, Jia P, Xu X, Xiao L, Yu G, Nan L, Sun X, Ge J, Wang J, Wang K, Liao Q, Wang Q, Wenwen Z, Yang S. The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: An exploratory study. Medicine (Baltimore) 2020; 99:e18776. [PMID: 32028390 PMCID: PMC7015565 DOI: 10.1097/md.0000000000018776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Liangshan Yi Autonomous Prefecture in Southwest China has a high human immunodeficiency virus (HIV) prevalence rate. This study examined the changing modes of HIV transmission among women with new HIV infections and explored the spatial heterogeneities in the factors associated with heterosexual transmission in this minority region.The data consisting of women with new HIV infections from 2011 to 2014 were collected from multiple sources. New infections were identified by BED capture enzyme immunoassay. The Bayesian hierarchical model was used to estimate the proportion of women with new HIV infections via heterosexual transmission across all townships in the Prefecture. A geographically weighted regression (GWR) model was utilized to investigate spatial variations in the sociodemographic characteristics associated with the changing modes of HIV transmission.An analytical sample of 927 women with new HIV infections was constructed and utilized to investigate the changing mode of HIV transmission. The rate of heterosexual transmission among women with new HIV infections in 2011 was below 20%. However, by 2014 this rate dramatically increased to nearly 80%. Among sociodemographic characteristics, GWR results revealed significant ethnic differences in heterosexual HIV transmission between Yi women and women in other ethnic groups, with Yi women demonstrating a lower risk of infection through heterosexual transmission. However, such ethnic differences were observed only in 30% of the townships in the Prefecture. Moreover, having a primary education decreased the odds of heterosexual transmission, which was observed in about 56% of the townships. Also, being involved in occupations other than agriculture or animal husbandry and being single or married decreased the odds of HIV infection through heterosexual contact among women, which did not significantly vary across the Prefecture.Heterosexual transmission was the predominant mode of HIV transmission among women in the Prefecture, and this transformation was clearly marked by a fast-growing trend and a spatial diffusion pattern. Spatial variations also existed in sociodemographic factors that were associated with the changing modes of HIV transmission.
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Affiliation(s)
- Chenghan Xiao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
- Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
| | - Xiaohe Xu
- School of Public Administration, Sichuan University, Chengdu
- Department of Sociology, The University of Texas at San Antonio, TX
| | - Lin Xiao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Lei Nan
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Xiaxia Sun
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Jingjing Ge
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Ke Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qiang Liao
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Qixing Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang
| | - Zhai Wenwen
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu
- International Initiative on Spatial Lifecourse Epidemiology (ISLE)
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13
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Li C, Yang Y, Wang Y, Dong S, Yang Y, Shi Y, Li L, Jiang F, Chen Y, Jiang Q, Zhou Y. Impact of maternal HIV-HBV coinfection on pregnancy outcomes in an underdeveloped rural area of southwest China. Sex Transm Infect 2020; 96:509-515. [PMID: 31911426 DOI: 10.1136/sextrans-2019-054295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/07/2019] [Accepted: 12/12/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Our objective was to determine the impact of maternal HIV-hepatitis B virus (HBV) coinfection on pregnancy outcomes. METHODS The current study was conducted in a county of Yi Autonomous Prefecture in southwest China. Data were abstracted from hospitalisation records, including maternal and infant information. The seroprevalences of HIV and HBV infections and HIV-HBV coinfection were determined and the impact of maternal HIV-HBV coinfection on adverse pregnancy outcomes was assessed using logistic regression analysis. A treatment effects linear regression model was also applied to examine the effect of HBV, HIV or coinfection to quantify the absolute difference in birth weight from a reference of HBV-HIV negative participants. RESULTS A total of 13 198 pregnant women were included in our study, and among them, 99.1% were Yi people and 90.8% lived in rural area. The seroprevalences of HIV and HBV infections and HIV-HBV coinfection were 3.6% (95% CI: 3.2% to 3.9%), 3.2% (95% CI: 2.9% to 3.5%) and 0.2% (95% CI: 0.1% to 0.2%) among the pregnant women, respectively. Maternal HIV-HBV coinfection was a risk factor for low birth weight (adjusted OR (aOR)=5.52, 95% CI: 1.97 to 15.40). Compared with the HIV mono-infection group, the risk of low birth weight was significantly higher in the HIV-HBV coinfection group (aOR=3.62, 95% CI: 1.24 to 10.56). Maternal HIV infection was associated with an increased risk of low birth weight (aOR=1.90, 95% CI: 1.38 to 2.60) and preterm delivery (aOR=2.84, 95% CI: 1.81 to 4.47). Perinatal death was more common when mothers were infected with HBV (aOR=2.85, 95% CI: 1.54 to 5.26). CONCLUSIONS The prevalence of HIV infection was high among pregnant women of the Yi region. Both HIV and HBV infections might have adverse effects on pregnancy outcomes. Maternal HIV-HBV coinfection might be a risk factor for low birth weight in the Yi region, which needs to be confirmed.
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Affiliation(s)
- Chunlin Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Yu Yang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Yingjian Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Shurong Dong
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Ya Yang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Ying Shi
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Linhan Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Feng Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Qingwu Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
| | - Yibiao Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China .,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.,Centre for Tropical Disease Research, Fudan University, Shanghai, China
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14
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Lou H, Ge X, Xu B, Liu W, Zhou YH. Prevention of Mother-to-Child Transmission of HIV: Data Analysis Based on Pregnant Women Population from 2012 to 2018, in Nantong City, China. Curr HIV Res 2020; 18:458-465. [PMID: 32778030 DOI: 10.2174/1570162x18666200810134025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND China has implemented a nation-wide policy to control mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) since 2011, yet the efficacy of the control policy is less studied. The aim of the present study was to report the data in the prevention of MTCT of HIV in Nantong city, China. METHODS The screening and prevalence of HIV in pregnant women and the efficacy of prophylaxis in Nantong city, China, January 2012 through December 2018, were analyzed. RESULTS Among a total population of 410,044 pregnant women, anti-HIV was tested prenatally in 393,658 (96.0%) women and in 16,287 (3.97%) women at delivery. In total, 51 women were confirmed with HIV infection. After the exclusion of repeat pregnancies, the overall prevalence of HIV infection was 1.20/10 000 (48/400,377). The prevalence (6.75/10,000) in women tested at delivery was >5-fold higher than that (1.02/10,000) in prenatally screened women. Of 48 HIV-infected women, 12 terminated their pregnancies and 36 others delivered 36 neonates, of whom 35 were followed up. No HIV infection occurred in 24 children born to mothers with antiretroviral therapy (ART) during pregnancy along with other preventive measures. Among 11 children born to mothers who did not receive ART during pregnancy because of the absence of a prenatal anti-HIV test, none of the 6 children who were delivered by cesarean section and timely administered neonatal antiretroviral prophylaxis was infected, but 2 (40%) of 5 children who were spontaneously delivered and administered delayed antiretroviral prophylaxis were infected. CONCLUSION Prenatal identification of HIV infection and timely administration of all preventive measures can completely block MTCT of HIV. The data indicate that more efforts must be taken to ensure that all pregnant women are tested for anti-HIV during pregnancy. For pregnant women who missed the prenatal screening, a positive result in rapid anti-HIV test at delivery should be sufficient to take preventive measures to prevent MTCT of HIV.
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Affiliation(s)
- Haiqin Lou
- Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China
| | - Xiaoyun Ge
- Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China
| | - Biyun Xu
- Department of Biostatistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Weiwei Liu
- Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China
| | - Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
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