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Author(s): Kelly B. Collins [1]; Bruce K. Patterson [2]; Gregory J. Naus [3]; Daniel V. Landers [3]; Phalguni Gupta (corresponding author) [1] Human immunodeficiency virus type 1 (HIV-1) infection in [...]

The HIV-1 virus in infected mothers appears to exhibit varying factors that can influence whether or not the virus is transmitted to children during pregnancy or delivery. Blood samples from 12 non-transmitting mothers were compared with blood samples from six transmitting mothers. The HIV-1 virus from transmitting mothers appeared to be better able and quicker at replicating itself. It also appeared to infect a larger variety of T-lymphocytic cell types. The virus isolates from non-transmitting mothers appeared to have a greater chance of being neutralized by the mothers' serum. A number of factors appear to influence whether or not the HIV-1 virus will be transmitted from an infected mother to her unborn child., Objective.--To evaluate the biological and serological properties of the human immunodeficiency virus type 1 (HIV-1) for factors potentially involved in the mother-to-child transmission of HIV-1. Design.--Isolates of HIV-1 were recovered from the blood of 12 of 44 nontransmitting mothers and six of eight transmitting mothers and their corresponding infants. These 24 HIV-1 isolates were compared for their biological and immunologic properties to discern any parameters that correlate with vertical transmission of HIV-1. Main Outcome Measures.--Replication capabilities of the above-mentioned HIV-1 isolates in human peripheral blood mononuclear cells (PBMCs), human macrophages, and various T-cell lines and the susceptibilities of the viruses to neutralization or enhancement by anti-HIV-1 antibodies in autologous serum samples from mothers and infants. Setting.--San Francisco Bay Area, California. Participants.--A cohort of 52 HIV-1-infected women and their infants in a prospective study on perinatal HIV transmission by the Bay Area Perinatal AIDS Center. Results.--The viral isolates from the transmitting mothers and their infants differed from the isolates from the nontransmitting mothers in their efficient replication in human PBMCs and in their ability to infect one or more human T-lymphocytic cell lines. All the HIV-1 isolates were able to infect human macrophages with only low-level replication and were unable to form syncytia in the MT-2-lymphocytic cells. No correlation between transmission and reactivity of maternal serum samples to the peptide corresponding to the principal neutralization domain of the third hypervariable region of the viral envelope was observed. However, the majority (9/12) of maternal isolates from the nontransmitters were neutralized by their autologous serum samples compared with only two among six in the transmitter group (P

There may be many ways to reduce the chance that an HIV-infected woman will transmit HIV to her newborn infant, but it is not clear how many women will be tested or treated. A 1994 study found that zidovudine taken during pregnancy and labor could reduce the risk of transmission. Newer drugs have been developed to fight HIV infection that could supplement zidovudine. However, all HIV-positive pregnant women would have to be identified and some might refuse treatment. So far there is no single policy to identify and treat all women and infants at risk.

Objective: To augment the understanding of parvovirus B19 infection in pregnancy with respect to maternal characteristics and their corresponding fetal outcomes.Study Design: Retrospective case-series of all women referred to Magee-Women_s Hospital with serologically-documented parvovirus B19 infection during pregnancy from 1998-2001.Results: All 25 cases that are available for analysis occurred from January through June. The frequency of cases varied substantially from year to year, with 14 cases in 1998, 0 cases in 1999 and 2000, and 11 cases in 2001. In contrast to previous reports, the minority of women [4/25(16%)] experienced symptoms attributable to parvovirus B-19 infection although 3 of 25 (12%) fetuses developed hydrops fetalis and 4/25 (16%) suffered an intrauterine of fetal death.Conclusions: These findings suggest that parvovirus B19 infection in pregnancy follows seasonal and annual trend variation, may produce a lower frequency of maternal symptoms and a higher fetal loss rate than previously reported. Synopsis. Maternal parvovirus B19 infection follows seasonal and annual variation is often asymptomatic and may have higher fetal loss rates than previously reported. Continued surveillance is warranted. [ABSTRACT FROM AUTHOR]

Objective. Vaginal breech (VB) delivery at term remains controversial. Our objective was to compare neonatal and maternal outcomes in VB deliveries selected using computed tomographic (CT) pelvimetry to those selected clinically. Methods. A retrospective cohort study of singleton, term, VB deliveries with adequate clinical pelvimetry and estimated fetal weight of 3,850?g was performed. Women in the CT group had adequate pelvimetry by CT measurements. Neonatal and maternal outcomes were recorded. Results. Of the VB deliveries, 58 women had adequate CT pelvimetry and 37 women were selected using clinical criteria alone. There were no perinatal deaths. Neonatal morbidity was significantly lower in VB deliveries selected using CT criteria at 0% versus 10.8% in the clinically selected group ( p ?=?0.02). Conclusion. VB deliveries selected using CT pelvimetry may be associated with fewer adverse neonatal outcomes than those selected using only clinical criteria. Therefore, it is inappropriate, without CT pelvimetry and strict selection criteria, to conclude that VB deliveries are unsafe. Our experience suggests that there may be a population in which VB delivery is a safe alternative if selected using a combination of specific clinical, sonographic, and CT criteria. [ABSTRACT FROM AUTHOR]

Provides information regarding the management for uncomplicated anogenital gonorrhea. Its etiology; Diagnosis; Treatment and prevention.

Discusses the synergy between HIV and sexually transmitted diseases (STD). Epidemiology; Association between HIV and syphilis; Impact of STD treatment on HIV transmission.

Objective: We sought to determine potential risk factors for upper genital tract inflammation in women with cervical Neisseria gonorrhoeae, Chlamydia trachomatis, or bacterial vaginosis.Study Design: In a case-controlled study we compared 111 women with cervical Neisseria gonorrhoeae, Chlamydia trachomatis, or bacterial vaginosis (the study group) with 24 women who had negative tests for each of these infections (the control group). We evaluated potential risk factors for upper genital tract inflammation by use of bivariate and then logistic regression analysis.Results: We found plasma cell endometritis in 53 of 111 women in the study group and 3 of 24 controls (odds ratio = 6.4, 95% confidence interval 1.7 to 35.0). On logistic regression, the study group women who were in the proliferative phase had increased likelihood of plasma cell endometritis (odds ratio = 4.5, 95% confidence interval 1.6 to 12.4).Conclusion: The proliferative phase of the menstrual cycle seems to be the primary risk factor for ascending infection by organisms associated with pelvic inflammatory disease. This may be due to a hormonal effect or to the loss of the cervical barrier during menstruation. [ABSTRACT FROM AUTHOR]