breastfeeding

Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004-2010

Antimicrobial drug resistance is a serious health hazard driven by overuse. Administration of antimicrobial drugs to HIV-exposed, uninfected infants, a population that is growing and at high risk for infection, is poorly studied. We therefore analyzed factors associated with antibacterial drug administration to HIV-exposed, uninfected infants during their first year of life.
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Legacy Evaluation of the Partnership for HIV-Free Survival: Kenya, Lesotho, Mozambique, South Africa, Tanzania, and Uganda

Author
David K. Hales, Heather B. Davis, Alexandra J. Munson, Emily A. Bobrow

The Partnership for HIV-Free Survival (PHFS) was designed to use basic quality improvement practices to reduce mother-to-child transmission of HIV and increase child survival through improvements in (1) antiretroviral therapy uptake and retention among HIV-positive pregnant women and mothers, (2) breastfeeding practices, and (3) overall mother-baby care. PHFS was implemented between 2012–2016 in six countries in Eastern and Southern Africa: Kenya, Lesotho, Mozambique, South Africa, Tanzania, and Uganda.

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Pregnant and breastfeeding women: A priority population for HIV viral load monitoring

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Yes
Author
Landon Myer, Shaffiq Essajee, Laura N. Broyles, D. Heather Watts, Maia Lesosky, Wafaa M. El-Sadr, Elaine J. Abrams

With more than 18 million HIV-infected individuals having initiated antiretroviral therapy (ART) in low- and middle-income countries (LMICs) by the end of 2016, ensuring effective HIV care and treatment services is a global public health priority. Viral load (VL) quantification provides a direct measure of the effectiveness of ART, with a consistently elevated VL suggesting poor adherence or treatment failure and the need for intervention.

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Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women: A Prospective Short-Term Study of Antiretroviral Excretion in Breast Milk and Infant Absorption

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Yes
Author
Kenneth K. Mugwanya , Craig W. Hendrix, Nelly R. Mugo, Mark Marzinke, Elly T. Katabira, Kenneth Ngure, Nulu B. Semiyaga, Grace John-Stewart, Timothy R. Muwonge, Gabriel Muthuri, Andy Stergachis, Connie L. Celum, Jared M. Baeten

As pre-exposure prophylaxis (PrEP) becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women.

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Detectable tenofovir levels in breast-feeding infants of mothers exposed to topical tenofovir

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Yes
Author
Noguchi LM, Montgomery ET, Biggio JR, Hendrix CW, Bogen DL, Hillier SL, Dai JY, Piper JM, Marzinke MA, Dezzutti CS, Isaacs SK, Schwartz JL, Watts DH, Beigi RH

Lactation studies are necessary evaluations of medications for reproductive-age women. We evaluated pharmacokinetics (PK), pharmacodynamics, safety, and adherence profiles associated with 7 days of 1% tenofovir (TFV) vaginal gel use during lactation. Tenofovir levels (maternal/infant serum, milk) and anti-HIV activity (milk), adverse events (AEs), and adherence were measured for 17 HIV-1-seronegative breast-feeding mother-infant pairs. Tenofovir use was well-tolerated and detected at low levels in maternal serum, milk, and infant serum but demonstrated no anti-HIV activity in milk.

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How real numbers can eliminate mother-to-child transmission of HIV

According to 2014 estimates from UNAIDS, between 3.4 million and 4.3 million women over 15 live with HIV in South Africa, while between 310,000 and 370,000 children in the country are HIV-positive.

In an age when countries can register nearly every mobile phone subscriber — and mobile phones are nearly ubiquitous — it is no longer acceptable, or ethical for that matter, for the public health community to work with HIV rate estimates that are “plus or minus” tens of thousands of people.

Author
Patricia Mechael
Source
Devex

HIV-exposed, uninfected infants: new global challenges in the era of paediatric HIV elimination

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Yes
Author
Ceri Evans, MBBCh, Christine E Jones, PhD, Dr Andrew J Prendergast, DPhil

The number of infants infected with HIV is declining with the rise in interventions for the elimination of paediatric HIV infection, but the number of uninfected infants exposed to HIV through their HIV-infected mothers is increasing. Interest in the health outcomes of HIV-exposed, uninfected infants has grown in the past decade, with several studies suggesting that these infants have increased mortality rates, increased infectious morbidity, and impaired growth compared with HIV-unexposed infants.

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A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention

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Yes
Author
Ambia J, Mandala J

Introduction: The success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps.

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Retention in care during the first 3 years of antiretroviral therapy for women in Malawi's option B+ programme: an observational cohort study

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Yes
Author
Andreas D Haas, Lyson Tenthani, Malango T Msukwa, Kali Tal, Andreas Jahn, Oliver J Gadabu, Adrian Spoerri, Frank Chimbwandira, Joep J van Oosterhout, Olivia Keiser

Studies of Malawi's option B+ programme for HIV-positive pregnant and breastfeeding women have reported high loss to follow-up during pregnancy and at the start of antiretroviral therapy (ART), but few data exist about retention during breastfeeding and after weaning. We examined loss to follow-up and retention in care in patients in the option B+ programme during their first 3 years on ART.

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HIV-Infected Ugandan Women on Antiretroviral Therapy Maintain HIV-1 RNA Suppression Across Periconception, Pregnancy, and Postpartum Periods

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Yes
Author
Matthews LT, Ribaudo HB, Kaida A, Bennett K, Musinguzi N, Siedner MJ, Kabakyenga J, Hunt PW, Martin JN, Boum Y, Haberer JE, Bangsberg DR

Background:

HIV-infected women risk sexual and perinatal HIV transmission during conception, pregnancy, childbirth, and breastfeeding. We compared HIV-1 RNA suppression and medication adherence across periconception, pregnancy, and postpartum periods, among women on antiretroviral therapy (ART) in Uganda.

Methods:

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