1,721,084 research outputs found
Mother-to-child transmission of human immunodeficiency virus in Italy: temporal trends and determinants of infection. The Italian Collaborative Study on HIV infection in pregnancy
No full textDoes highly active antiretroviral therapy increase the risk of congenital abnormalities in HIV- infected women?
No full textCaesarean section and risk of vertical transmission of HIV 1 infection
No full textIndirect evidence suggests that a significant proportion of vertical transmission of HIV infection occurs late in pregnancy or during delivery. Caesarean section, therefore, may protect the fetus from infection. We looked at 1254 HIV-infected mothers and their children and the effects of different modes of delivery on transmission risk. We also included a detailed assessment of confounding factors associated with transmission risk. Women who had caesarean sections were more advanced in their disease progression which may cause the protective effect of caesarean section to be underestimated. When this and other potential confounding factors were taken into account, caesarean section was estimated to halve the rate of transmission. This finding is important in the design of studies to evaluate treatments aimed at reducing mother-to-child transmission
Caesarean section and risk of vertical transmission of HIV-1 infection
No full textIndirect evidence suggests that a significant proportion of vertical transmission of HIV infection occurs late in pregnancy or during delivery. Caesarean section, therefore, may protect the fetus from infection. We looked at 1254 HIV-infected mothers and their children and the effects of different modes of delivery on transmission risk. We also included a detailed assessment of confounding factors associated with transmission risk. Women who had caesarean sections were more advanced in their disease progression which may cause the protective effect of caesarean section to be underestimated. When this and other potential confounding factors were taken into account, caesarean section was estimated to halve the rate of transmission. This finding is important in the design of studies to evaluate treatments aimed at reducing mother-to-child transmission
Combination antiretroviral therapy and duration of pregnancy
Get PDFObjective: To assess the association between type and timing of initiation of antiretroviral therapy in pregnancy and duration of pregnancy.
Design: Prospective study.
Methods: Data on 3920 mother-child pairs were examined (3075 mother-child pairs from the European Collaborative Study and 905 from the Swiss Mother + Child HIV Cohort Study). Factors examined included gestational age, antiretroviral therapy during pregnancy, maternal CD4 count, viral load, illicit drug use (IDU) and mode of delivery. Deliveries at less than 37 weeks were defined as premature.
Results: The prematurity rate was 17% and median gestational age 39 weeks. Twenty-three per cent (896 of 3920) of women received antiretroviral therapy during pregnancy: 64% (573 of 896) zidovudine monotherapy, 24% (215) combination therapy without protease inhibitors (PI) and 12% (108) combination therapy with PI. In multivariate analysis, adjusted for maternal CD4 count and IDU, odds ratio (OR) of prematurity was 2.60 [95% confidence interval (CI), 1.43-4.75] and 1.82 (95% CI, 1.13-2.92) for infants exposed to combination therapy with and without a PI, respectively, compared to no treatment. Exposure to monotherapy was not associated with prematurity, but severe immunosuppression and IDU in pregnancy were. Women on combination therapy from before pregnancy were twice as likely to deliver prematurely as those starting therapy in the third trimester (OR, 2.17; 95% Cl, 1.034.58).
Conclusions: Pregnancy issues should be discussed when making decisions about initiation of combination antiretroviral therapy for HIV-infected women. Elective caesarean section to reduce vertical transmission at 36 weeks rather than 38 weeks may be advisable in women on combination therapy with PI
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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