scholarly journals Tuberculosis in Pregnancy: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Olabisi M. Loto ◽  
Ibraheem Awowole
Keyword(s):  
Causes Of Death ◽  
Preventive Therapy ◽  
Normal Weight ◽  
Hiv Positive ◽  
First Line ◽  
Successful Control ◽  
Normal Weight Gain ◽  
Inh Prophylaxis ◽  
Prevention Of Hiv ◽  
In Pregnancy

Tuberculosis (TB) was declared a public health emergency by WHO in 2005. The disease is a significant contributor to maternal mortality and is among the three leading causes of death among women aged 15–45 years in high burden areas. The exact incidence of tuberculosis in pregnancy, though not readily available, is expected to be as high as in the general population. Diagnosis of tuberculosis in pregnancy may be challenging, as the symptoms may initially be ascribed to the pregnancy, and the normal weight gain in pregnancy may temporarily mask the associated weight loss. Obstetric complications of TB include spontaneous abortion, small for date uterus, preterm labour, low birth weight, and increased neonatal mortality. Congenital TB though rare, is associated with high perinatal mortality. Rifampicin, INH and Ethambutol are the first line drugs while Pyrazinamide use in pregnancy is gaining popularity. Isoniazid preventive therapy is a WHO innovation aimed at reducing the infection in HIV positive pregnant women. Babies born to this mother should be commenced on INH prophylaxis for six months, after which they are vaccinated with BCG if they test negative. Successful control of TB demands improved living conditions, public enlightenment, primary prevention of HIV/AIDS and BCG vaccination.

Persistence of novel first-line antiretroviral regimes in a cohort of HIV-positive subjects, CoRIS 2008–2010

2012 ◽  
Vol 18 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Inma Jarrin ◽  
◽  
Beatriz Hernández-Novoa ◽  
Belén Alejos ◽  
Melchor Riera ◽  
...  
Keyword(s):  
Hiv Positive ◽  
First Line

scholarly journals A Rare Case of Pyoderma Gangrenosum in a HIV Positive Patient

2011 ◽  
Vol 2 (2) ◽  
pp. 128-130
Author(s):  
Eswari Loganathan ◽  
Asima Banu
Keyword(s):  
Pyoderma Gangrenosum ◽  
Rare Case ◽  
Positive Patient ◽  
Neutrophilic Dermatosis ◽  
Hiv Positive ◽  
Medical Sciences ◽  
First Line ◽  
Hodgkins Lymphoma ◽  
Lymphoid Malignancies ◽  
Non Hodgkins Lymphoma

HIV infection can lead to varied spectrum of associated disease conditions. Pyoderma gangrenosum is a neutrophilic dermatosis that may be associated with myeloid malignancies. Less information is available about the association of pyoderma gangrenosum with lymphoid malignancies. We report a rare case of pyoderma gangrenosum in association with Non hodgkins lymphoma(NHL) of diffuse large B cell type. In this case the lesion which showed NHL features occurred in the perianal region, coexisting with pyoderma gangrenosum lesions in the perianal, lower limb and abdominal region. Another interesting feature is the occurrence of both these conditions in a HIV-positive patient with severe immunologic failure to first line antiretroviral therapy contributing to the refractoriness to treatment. Key Words: HIV; pyoderma gangrenosum; Non Hodgkins Lymphoma DOI: http://dx.doi.org/10.3126/ajms.v2i2.4029 Asian Journal of Medical Sciences 2 (2011) 128-130

Dolutegravir in pregnancy—effects on HIV-positive women and their infants

2018 ◽  
Vol 37 (3) ◽  
pp. 495-500 ◽  
Author(s):  
Riikka Bornhede ◽  
Sandra Soeria-Atmadja ◽  
Katarina Westling ◽  
Karin Pettersson ◽  
Lars Navér
Keyword(s):  
Hiv Positive ◽  
Hiv Positive Women ◽  
In Pregnancy

scholarly journals The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Smith-Wade ◽  
Giselle Kidson-Gerber ◽  
Antonia Shand ◽  
Luke Grzeskowiak ◽  
Amanda Henry
Keyword(s):  
New Zealand ◽  
Iron Deficiency ◽  
Online Survey ◽  
Controlled Trial ◽  
Perinatal Outcomes ◽  
Intravenous Iron ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
In Pregnancy

Abstract Background Iron deficiency anaemia in pregnancy (IDAP) affects 11–18% of Australian pregnancies and is associated with adverse perinatal outcomes. National prescribing data suggests the use of intravenous iron in pregnancy is increasingly common. This study aimed to: 1) Establish the current patterns of intravenous iron use by Fellows of the Royal Australian and New Zealand College of Obstetricians (FRANZCOG) when treating iron deficiency and IDAP including immediately postpartum and; 2) Assess FRANZCOG opinions regarding potential trial of intravenous iron for first-line treatment of IDAP. Methods An online survey of RANZCOG Fellows practicing obstetrics was distributed in September 2018. Results were analysed descriptively and responses compared by clinician demographics using Chi-squared testing. Results Of 484 respondents (21% of FRANZCOG), 457 were currently practicing obstetrics. Most prescribed intravenous iron in pregnancy (96%) and/or postpartum (85%). Most intravenous iron was prescribed for IDAP (98%) rather than iron deficiency without anaemia (53%), and for IDAP most commonly second-line to failed oral iron supplementation and first-line in special circumstances (59%). Intravenous iron prescribing was associated with shorter time since FRANZCOG completion (p = 0.01), public hospital practice (p = 0.008) and higher hospital birth numbers (p = 0.01). Most respondents (90%) would consider a randomised controlled trial of first-line intravenous iron for IDAP, although views on appropriate thresholds differed. Conclusions Almost all respondents prescribed intravenous iron for IDAP, and while mostly used for second-line treatment over half sometimes used it first-line. With accelerating intravenous iron use, further research is required into its optimal use in pregnancy, recognizing important clinical outcomes and cost effectiveness.

scholarly journals Declining Trends in Childhood TB Notifications and Profile of Notified Patients in the City of Harare, Zimbabwe, from 2009 to 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Phoebe Nzombe ◽  
Srinath Satyanarayana ◽  
Hannock Tweya ◽  
Collins Timire ◽  
Kelvin Charambira ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Scale Up ◽  
Preventive Therapy ◽  
Hiv Positive ◽  
Drug Resistant ◽  
Pulmonary Tb ◽  
Childhood Tb ◽  
Clinical Profiles ◽  
The City

Globally, childhood tuberculosis (TB among those aged <15 years) is a neglected component of national TB programmes in high TB burden countries. Zimbabwe, a country in southern Africa, is a high burden country for TB, TB-HIV, and drug-resistant TB. In this study, we assessed trends in annual childhood TB notifications in Harare (the capital of Zimbabwe) from 2009 to 2018 and the demographic, clinical profiles, and treatment outcomes of childhood TB patients notified from 2015–2017 by reviewing the national TB programme records and reports. Overall, there was a decline in the total number of TB patients (all ages) from 5,943 in 2009 to 2,831 in 2018. However, the number of childhood TB patients had declined exponentially 6-fold from 583 patients (117 per 100,000 children) in 2009 to 107 patients (18 per 100,000 children) in 2018. Of the 615 childhood TB patients notified between 2015 and 2017, 556 (89%) patient records were available. There were 53% males, 61% were aged <5 years, 92% were new TB patients, 85% had pulmonary TB, and 89% were treated for-drug sensitive TB, 3% for drug-resistant TB, and 40% were HIV positive (of whom 59% were on ART). Although 58% had successful treatment outcomes, the treatment outcomes of 40% were unknown (not recorded or not evaluated), indicating severe gaps in TB care. The disproportionate decline in childhood TB notifications could be due to the reduction in the TB burden among HIV positive individuals from the scale up of antiretroviral therapy and isoniazid preventive therapy. However, the country is experiencing economic challenges which could also contribute to the disproportionate decline in childhood TB notification and gaps in quality of care. There is an urgent need to understand the reasons for the declining trends and the gaps in care.

Characterisation of Mutated Proteinases Derived from HIV-Positive Patients: Enzyme Activity, Vitality and Inhibition

2004 ◽  
Vol 69 (3) ◽  
pp. 703-714 ◽  
Author(s):  
Milan Kožíšek ◽  
Jana Prejdová ◽  
Milan Souček ◽  
Ladislav Machala ◽  
Marie Staňková ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Multidrug Resistant ◽  
Hiv Protease ◽  
Progeny Virus ◽  
Hiv Positive ◽  
Virus Infectivity ◽  
Virus Particles ◽  
Highly Active ◽  
Successful Control ◽  
Infectious Progeny Virus

HIV protease (PR) specifically cleaves viral polyproteins to yield infectious progeny virus particles. Inactivation of PR leads to loss of virus infectivity and PR thus became an attractive pharmaceutic target. Indeed, seven protease inhibitors (PI) have been approved for clinical use to date. However, emerging resistant viral variants with reduced sensitivity to PIs become a major obstacle to successful control of viral replication. We have previously reported the design, testing and structural analysis of a pseudopeptide inhibitor, QF34, which efficiently inhibits a wide variety of PR variants. In a clinical study, we have monitored more than 100 HIV-positive patients in the Czech Republic undergoing highly active antiretroviral therapy including PI. In this paper we describe kinetic characterisation of two highly resistant PR species isolated from these patients. The mutated proteases accumulated as much as 14 amino acid exchanges and develop resistance to saquinavir, ritonavir, indinavir and nelfinavir with vitality value up to 150. Kinetic analyses revealed that second-generation PI lopinavir and QF34 retained their subnanomolar potency against both multidrug resistant PR variants. These results suggest a route to the design of PIs capable of inhibiting a variety of resistant PR mutants.

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