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3. Risk of Perinatal HIV Infection in Infants Born in Italy to Immigrant Mothers

Author

Chiappini, Elena, Galli, Luisa, Lisi, Catiuscia, Gabiano, Clara, Giaquinto, Carlo, Giacomet, Vania, Buffolano, W., Esposito, Susanna, Badolato, Raffaele, Berbardi, S., Cellini, Monica, Dodi, Icilio, Faldella, Giacomo, Osimani, Patrizia, Genovese, Orazio, Nicastro, Emanuele, Viscoli, Claudio, Salvini, Federico, Tovo, Pier-Angelo, and de Martino, Maurizio

Published
2011
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6. Missed opportunities to prevent mother-to-child transmission of HIV in Italy

Author

Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, Tk., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E, De Martino, M, Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Chiappini, E., Gervaso, P., Montagnani, C., De Martino, M., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, Pa., Silvestro, E., Virano, S., Portelli, V., Pellegatta, A., Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, T. K., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E., De Martino, M., Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Gervaso, P., Montagnani, C., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, P. A., Silvestro, E., Virano, S., Portelli, V., and Pellegatta, A.

Subjects
Male, 0301 basic medicine, Pediatrics, newborns, medicine.medical_treatment, children, HIV, missed opportunities, mothers, pregnancy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Health Services Accessibility, Health Policy, Infectious Diseases, Pharmacology (medical), 0302 clinical medicine, newborn, Childbirth, Registries, 030212 general & internal medicine, Pregnancy Complications, Infectious, Transmission (medicine), mother, virus diseases, Settore MED/38, children, HIV, missed opportunities, mothers, newborns, pregnancy, Italy, Female, medicine.medical_specialty, Mother to child transmission, Anti-HIV Agents, Prenatal care, Risk Assessment, 03 medical and health sciences, medicine, Humans, Caesarean section, Peripartum Period, Pregnancy, Cesarean Section, business.industry, Infant, Newborn, Infant, medicine.disease, 030112 virology, Infectious Disease Transmission, Vertical, missed opportunitie, business
Abstract

OBJECTIVES: Vertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother-to-child transmission of HIV. METHODS: The Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. RESULTS: We found 79 HIV-1-infected children newly diagnosed after birth in Italy. Thirty-two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty-one newborns received antiretroviral prophylaxis and 39 received infant formula. CONCLUSIONS: We found an unacceptable number of missed opportunities to prevent mother-to-child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns.

Published
2019

9. Determinants of response to a parent questionnaire about development and behaviour in 3 year olds: European multicentre study of congenital toxoplasmosis

Author

Schmidt D, Malm G, Buffolano W, Ferret N, Prusa A, Freeman K, Salt A, Tan HK, and Gilbert RE

Subjects
Pediatrics, RJ1-570
Abstract

Abstract Background We aimed to determine how response to a parent-completed postal questionnaire measuring development, behaviour, impairment, and parental concerns and anxiety, varies in different European centres. Methods Prospective cohort study of 3 year old children, with and without congenital toxoplasmosis, who were identified by prenatal or neonatal screening for toxoplasmosis in 11 centres in 7 countries. Parents were mailed a questionnaire that comprised all or part of existing validated tools. We determined the effect of characteristics of the centre and child on response, age at questionnaire completion, and response to child drawing tasks. Results The questionnaire took 21 minutes to complete on average. 67% (714/1058) of parents responded. Few parents (60/1058) refused to participate. The strongest determinants of response were the score for organisational attributes of the study centre (such as direct involvement in follow up and access to an address register), and infection with congenital toxoplasmosis. Age at completion was associated with study centre, presence of neurological abnormalities in early infancy, and duration of prenatal treatment. Completion rates for individual questions exceeded 92% except for child completed drawings of a man (70%), which were completed more by girls, older children, and in certain centres. Conclusion Differences in response across European centres were predominantly related to the organisation of follow up and access to correct addresses. The questionnaire was acceptable in all six countries and offers a low cost tool for assessing development, behaviour, and parental concerns and anxiety, in multinational studies.

Published
2005
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10. The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection

Author

Calitri C, Gabiano C, Galli L, Chiappini E, Giaquinto C, Buffolano W, Genovese O, Esposito S, Bernardi S, De Martino M, Tovo PA, Italian Register for HIV Infection in Children, Lo Vecchio A., Calitri, C, Gabiano, C, Galli, L, Chiappini, E, Giaquinto, C, Buffolano, W, Genovese, O, Esposito, S, Bernardi, S, De Martino, M, Tovo, Pa, Italian Register for HIV Infection in, Children, and Lo Vecchio, A.

Subjects
HIV
Abstract

BACKGROUND: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing. METHODS: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children. RESULTS: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 - 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection. CONCLUSIONS: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

Published
2014

11. Duration of ruptured membranes and vertical transmission of HIV-1: a meta-analysis from 15 prospective cohort studies

Author

Bulterys, M. B., Fowler, M. G., Hanson, I. C., Lemay, M., Mayaux, M. J., Mofenson, L., Newell, M. -L., Peavy, H., Peckham, C., Read, J. S., Rother, C., Simpson, B. J., Van Dyke, R. B., Harris, D. R., Peavy, H. H., Easley, K., Khammy, A., Nugent, R. P., Mitchell, R., Owen, W., Van Dyke, R., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Krogstad, P., Mullins, J., Wolinsky, S., Korber, B., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Lapointe, N., Boucher, M., Fauvel, M., Hankins, C., Samson, J., Newell, M. L., Peckham, C. S., Thorne, C. N., Giaquinto, C., Ruga, E., De Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., de Alba, C., Garcia Rodriguez, M. C., Bates, I., de Josee, I., Hawkins, F., Martinez Zapico, R., Pena, J. M., Gonzalez Garcia, J., Arribas Lopez, J. R., Asensi-Botet, F., Otero, M. C., Peerez-Tamarit, D., Moya, A., Galbis, M. J., Scherpbier, H., Boer, K., Bohlin, A. B., Lindgren, S., Anzen, B., Belfrage, E., Lidin-Jansson, G., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Ferrazin, A., De Maria, A., Gotta, C., Mur, A., Vinolas, M., Paya, A., Loepez-Vilchez, M. A., Coll, O., Fortuny, C., Boguna, J., Casellas Caro, M., Canet, Y., Pardi, G., Ravizza, M., Semprini, E., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Zanelli, S., Duse, M., Soresina, A., Scaravelli, G., Stegagno, M., De Santis, M., Muggiasca, M. L., Vigano, A., Spinillo, A., Ravagni Probizer, F., Bucceri, A., Rancilio, L., Taylor, G. P., Lyall, H., Penn, Z., Blott, M., Valerius, N. H., Martinelli, P., Buffolano, W., Tibaldi, C., Ziarati, N., Semprini, A., Della Torre, M., Parazzini, F., Dallacasa, P., Bianchi, U., Pachi, A., Mancuso, S., Villa, P., Conti, M., Principi, N., Muggiasca, M., Marchisio, P., Zara, C., Ravagni, F., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tadrist, B., Thevenieau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, N., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J., Delattre, P., Stien, L., Audibert, F., Labrune, P., Vial, M., Mazy, F., Sitbon, D., Crenn-Hebert, C., Floch-Tudal, C., Akakpo, R., Daveau, C., Leblanc, A., Cesbron, P., Duval-Arnould, M., Huraux-Rendu, C., Lemerle, S., Touboul, C., Guerin, M., Maingueneau, C., Reynaud, I., Rousseau, T., Ercoil, V., Lanza, M., Denavit, M., Garnier, J., Lahsinat, K., Pia, P., Allouche, C., Nardou, M., Grall, F., May, A., Dallot, M., Lhuillier, P., Cecile, W., Mezin, R., Bech, A., Lobut, J., Algava, G., Chalvon Dermesay, A., Busuttil, R., Jacquemot, M., Bader-Meunier, B., Fridman, S., Codaccioni, X., Maxingue, F., Thomas, D., Alain, J., De Lumley, L., Tabaste, J., Bailly Salin, P., Seaume, H., Guichard, A., Kebaill, K., Roussouly, C., Botto, C., De Lanete, A., Wipff, P., Cravello, L., De Boisse, P., Leclaire, M., Michel, G., Crumiere, C., Lefevre, V., Le Lorier, B., Pauly, I., Robichez, B., Seguy, D., Delhinger, M., Rideau, F., Talon, P., Benos, P., Huret, C., Nicolas, J., Heller-Roussin, B., Saint-Leger, S., Delaporte, M., Hubert, C., De Sarcus, B., Karoubi, P., Mechinaud, F., Bertcrottiere, D., Bongain, A., Monpoux, F., De Gennes, C., Devianne, F., Nisand, I., Rousset, M., Mouchnino, G., Muray, J., Munzer, M., Quereux, C., Brossard, V., Clavier, B., Allemon, M., Rotten, D., Stephan, J., Varlet, M., Guyot, B., Narcy, P., Bardinet, F., De Caunes, F., Jeny, R., Robin, M., Raison Boulley, A., Savey, L., Berrebi, A., Tricoire, J., Borderon, J., Fignon, A., Guillot, F., Maria, B., Broyard, A., Chitrit, Y., Firtion, G., Mandelbrot, L., Lafay Pillet, M., Parat, S., Boissinot, C., Garec, N., Levine, M., Ottenwalter, A., Schaller, F., Vilmer, E., Courpotin, C., Brunner, C., Ciraru-Vigneron, N., Hatem-Gantzer, G., Fritel, X., Wallet, A., Bouille, J., Milliez, J., Bensaid Mrejen, D., Dermer, E., Noseda, G., Bardou, D., Cressaty, J., Francoual, C., Carlus Moncomble, C., Cohen, H., Blanche, S., Bastion, H., Benifla, J., Benkhatar, F., Berkane, N., Hervee, F., Ronzier, M., Mayaux, Mj., de Martino, M., Tovo, P. -A., Galli, L., Gabiano, C., Ferraris, G., Garetto, S., Palomba, E., Riva, C., Vierucci, A., de Luca, M., Farina, S., Fundaro, C., Genovese, O., Mereu, G., Forni, G. L., Casadei, A., Zuccotti, G. V., Riva, E., Cellini, M., Baraldi, C., Consolini, R., Palla, G., Ruggeri, M., Ciccimarra, F., Guarino, A., Osimani, P., Benaglia, G., Romano, A., De Mattia, D., Caselli, D., Boni, S., Dell'Erba, G., Bassanetti, F., Sticca, M., Timpano, C., Magnani, C., Salvatore, C., Lipreri, R., Tornaghi, R., Pinzani, R., Cecchi, M. T., Bezzi, T., Battisti, L., Bresciani, E., Castelli Gattinara, G., Nasi, C., Pellegatta, A., Mazza, A., Baldi, F., Altobelli, R., Deiana, M., Colnaghi, C., Tarallo, L., Tondo, U., Anastasio, E., Chiriaco, P. G., Ruggeri, C., Scott, G., Hutto, C., O'Sullivan, M., Malmsberry, A., Willoughby, A., Burns, D., Goedert, J., Landesman, S., Minkoff, H., Mendez, H., Holman, S., Rubinstein, A., Durako, S., Muenz, L., Goodwin, S., Bryson, Y., Dillon, M., Nielsen, K., Boyer, P., Liao, D., Keller, M., Deveikis, A., Nesheim, S., Lindsay, M., Lee, F., Nahmias, A., Sawyer, M., Vink, P., Farley, J., Alger, L., Abrams, E., Bamji, M., Lambert, G., Schoenbaum, E., Thomas, P., Weedon, J., Palumbo, P., Denny, T., Oleske, J., Bulterys, M., Simonds, R., Ethier-Ives, J., Rogers, M., Schluchter, M., Kutner, M., Kaplan, S., Kattan, M., Lipshultz, S., Mellins, R., Shearer, W., Sopko, G., Sloand, E., Wu, M., Kind, C., Nadal, D., Rudin, C., Siegrist, C. -A., Wyler, C. -A., Cheseaux, J. -J., Aebi, C., Gnehm, H., Schubiger, G., Klingler, J., Hunziker, U., Kuchler, H., Gianinazzi, M., Buhlmann, U., Biedermann, K., Lauper, U., Irion, O., Brunelli, A., Spoletini, G., Schreyer, A., Hosli, I., Saurenmann, E., Drack, G., Isenschmid, M., Poorbeik, M., Schupbach, J., Perrin, L., Erb, P., Joller, H., Kovacs, A., Stek, A., Chan, L., Khoury, M., Diaz, C., Pacheco-Acosta, E., Tuomala, R., Cooper, E., Mesthene, D., Pitt, J., Higgins, A., Moroso, G., Rich, K., Turpin, D., Cooper, N., Davenny, K., Thompson, B., Andiman, W., Simpson, J., THE INTERNATIONAL PERINATAL HIV, Group, Martinelli, Pasquale, Bulterys M.B., Fowler M.G., Hanson I.C., Lemay M., Mayaux M.J., Mofenson L., Newell M.-L., Peavy H., Peckham C., Read J.S., Rother C., Simpson B.J., Van Dyke R.B., Harris D.R., Peavy H.H., Easley K., Khammy A., Nugent R.P., Mitchell R., Owen W., Van Dyke R., Widmayer S., Bardeguez A., Hanson C., Wiznia A., Luzuriaga K., Viscarello R., Ho D., Koup R., Chen I., Krogstad P., Mullins J., Wolinsky S., Korber B., Walker B., Ammann A., Clapp S., McDonald D., Lapointe N., Boucher M., Fauvel M., Hankins C., Samson J., Newell M.L., Peckham C.S., Thorne C.N., Giaquinto C., Ruga E., De Rossi A., Truscia D., Grosch-Worner I., Schafer A., Mok J., Johnstone F., Jiminez J., de Alba C., Garcia Rodriguez M.C., Bates I., de Josee I., Hawkins F., Martinez Zapico R., Pena J.M., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Peerez-Tamarit D., Moya A., Galbis M.J., Scherpbier H., Boer K., Bohlin A.B., Lindgren S., Anzen B., Belfrage E., Lidin-Jansson G., Levy J., Barlow P., Hainaut M., Peltier A., Ferrazin A., De Maria A., Gotta C., Mur A., Vinolas M., Paya A., Loepez-Vilchez M.A., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Semprini E., Castagna C., Fiore S., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Zanelli S., Duse M., Soresina A., Scaravelli G., Stegagno M., De Santis M., Muggiasca M.L., Vigano A., Spinillo A., Ravagni Probizer F., Bucceri A., Rancilio L., Taylor G.P., Lyall H., Penn Z., Blott M., Valerius N.H., Martinelli P., Buffolano W., Tibaldi C., Ziarati N., Semprini A., Della Torre M., Parazzini F., Dallacasa P., Bianchi U., Pachi A., Mancuso S., Villa P., Conti M., Principi N., Muggiasca M., Marchisio P., Zara C., Ravagni F., Vignali M., Rossi G., Selvaggi L., Greco P., Vimercati A., Massi G., Innocenti T., Fiscella A., Sansone M., Benedetto C., Tadrist B., Thevenieau D., Gondry J., Paulard B., Alisy C., Brault D., Tordjeman N., Mamou J., Rozan M., Colombani D., Pincemaille O., Salvetti A., Chabanier C., Hernandorena X., Leroy J., Schaal J., Balde P., Faucher P., Lachassinne E., Benoit S., Douard D., Hocke C., Barjot P., Brouard J., Delattre P., Stien L., Audibert F., Labrune P., Vial M., Mazy F., Sitbon D., Crenn-Hebert C., Floch-Tudal C., Akakpo R., Daveau C., Leblanc A., Cesbron P., Duval-Arnould M., Huraux-Rendu C., Lemerle S., Touboul C., Guerin M., Maingueneau C., Reynaud I., Rousseau T., Ercoil V., Lanza M., Denavit M., Garnier J., Lahsinat K., Pia P., Allouche C., Nardou M., Grall F., May A., Dallot M., Lhuillier P., Cecile W., Mezin R., Bech A., Lobut J., Algava G., Chalvon Dermesay A., Busuttil R., Jacquemot M., Bader-Meunier B., Fridman S., Codaccioni X., Maxingue F., Thomas D., Alain J., De Lumley L., Tabaste J., Bailly Salin P., Seaume H., Guichard A., Kebaill K., Roussouly C., Botto C., De Lanete A., Wipff P., Cravello L., De Boisse P., Leclaire M., Michel G., Crumiere C., Lefevre V., Le Lorier B., Pauly I., Robichez B., Seguy D., Delhinger M., Rideau F., Talon P., Benos P., Huret C., Nicolas J., Heller-Roussin B., Saint-Leger S., Delaporte M., Hubert C., De Sarcus B., Karoubi P., Mechinaud F., Bertcrottiere D., Bongain A., Monpoux F., De Gennes C., Devianne F., Nisand I., Rousset M., Mouchnino G., Muray J., Munzer M., Quereux C., Brossard V., Clavier B., Allemon M., Rotten D., Stephan J., Varlet M., Guyot B., Narcy P., Bardinet F., De Caunes F., Jeny R., Robin M., Raison Boulley A., Savey L., Berrebi A., Tricoire J., Borderon J., Fignon A., Guillot F., Maria B., Broyard A., Chitrit Y., Firtion G., Mandelbrot L., Lafay Pillet M., Parat S., Boissinot C., Garec N., Levine M., Ottenwalter A., Schaller F., Vilmer E., Courpotin C., Brunner C., Ciraru-Vigneron N., Hatem-Gantzer G., Fritel X., Wallet A., Bouille J., Milliez J., Bensaid Mrejen D., Dermer E., Noseda G., Bardou D., Cressaty J., Francoual C., Carlus Moncomble C., Cohen H., Blanche S., Bastion H., Benifla J., Benkhatar F., Berkane N., Hervee F., Ronzier M., Mayaux MJ., de Martino M., Tovo P.-A., Galli L., Gabiano C., Ferraris G., Garetto S., Palomba E., Riva C., Vierucci A., de Luca M., Farina S., Fundaro C., Genovese O., Mereu G., Forni G.L., Casadei A., Zuccotti G.V., Riva E., Cellini M., Baraldi C., Consolini R., Palla G., Ruggeri M., Ciccimarra F., Guarino A., Osimani P., Benaglia G., Romano A., De Mattia D., Caselli D., Boni S., Dell'Erba G., Bassanetti F., Sticca M., Timpano C., Magnani C., Salvatore C., Lipreri R., Tornaghi R., Pinzani R., Cecchi M.T., Bezzi T., Battisti L., Bresciani E., Castelli Gattinara G., Nasi C., Pellegatta A., Mazza A., Baldi F., Altobelli R., Deiana M., Colnaghi C., Tarallo L., Tondo U., Anastasio E., Chiriaco P.G., Ruggeri C., Scott G., Hutto C., O'Sullivan M., Malmsberry A., Willoughby A., Burns D., Goedert J., Landesman S., Minkoff H., Mendez H., Holman S., Rubinstein A., Durako S., Muenz L., Goodwin S., Bryson Y., Dillon M., Nielsen K., Boyer P., Liao D., Keller M., Deveikis A., Nesheim S., Lindsay M., Lee F., Nahmias A., Sawyer M., Vink P., Farley J., Alger L., Abrams E., Bamji M., Lambert G., Schoenbaum E., Thomas P., Weedon J., Palumbo P., Denny T., Oleske J., Bulterys M., Simonds R., Ethier-Ives J., Rogers M., Schluchter M., Kutner M., Kaplan S., Kattan M., Lipshultz S., Mellins R., Shearer W., Sopko G., Sloand E., Wu M., Kind C., Nadal D., Rudin C., Siegrist C.-A., Wyler C.-A., Cheseaux J.-J., Aebi C., Gnehm H., Schubiger G., Klingler J., Hunziker U., Kuchler H., Gianinazzi M., Buhlmann U., Biedermann K., Lauper U., Irion O., Brunelli A., Spoletini G., Schreyer A., Hosli I., Saurenmann E., Drack G., Isenschmid M., Poorbeik M., Schupbach J., Perrin L., Erb P., Joller H., Kovacs A., Stek A., Chan L., Khoury M., Diaz C., Pacheco-Acosta E., Tuomala R., Cooper E., Mesthene D., Pitt J., Higgins A., Moroso G., Rich K., Turpin D., Cooper N., Davenny K., Thompson B., Andiman W., and Simpson J.

Subjects
Time Factors, Epidemiology, Infectious Disease Transmission, Prevention of perinatal transmission, Extraembryonic Membranes, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, Pregnancy, Risk Factors, INFECTION, Vertical, Immunology and Allergy, HIV Infection, MOTHER-TO-CHILD, Pregnancy Complications, Infectious, Prospective cohort study, prevention of perinatal transmission, vertical transmission, obstetrics/gynaecology, epidemiology, Obstetrics, Transmission (medicine), Infectious, HUMAN-IMMUNODEFICIENCY-VIRUS, MOTHER-TO-CHILD, ZIDOVUDINE PROPHYLAXIS, RISK-FACTORS, TYPE-1, PREGNANCY, INFECTION, TRIAL, PREVENTION, Breast Feeding, Infectious Diseases, Meta-analysis, HUMAN-IMMUNODEFICIENCY-VIRUS, Vertical transmission, Regression Analysis, TRIAL, Female, Delivery, Obstetrics gynaecology, Human, medicine.medical_specialty, Time Factor, Ruptured membranes, Immunology, Regression Analysi, NO, ZIDOVUDINE PROPHYLAXIS, Extraembryonic Membrane, medicine, Humans, TYPE-1, business.industry, Risk Factor, Infant, Newborn, Infant, Obstetric, Delivery, Obstetric, Newborn, PREVENTION, Infectious Disease Transmission, Vertical, Pregnancy Complications, Obstetrics/gynaecology, RISK-FACTORS, Cohort Studie, business
Abstract

Objective: To test the a priori hypothesis that longer duration of ruptured membranes is associated with increased risk of vertical transmission of HIV. Design: The relationship between duration of ruptured membranes and vertical transmission of HIV was evaluated in an individual patient data meta-analysis. Methods: Eligible studies were prospective cohort studies including at least 100 mother-child pairs, from regions where HIV-infected women are counselled not to breastfeed. Analyses were restricted to vaginal deliveries and non-elective Cesarean sections; elective Cesarean section deliveries (those performed before onset of labour and before rupture of membranes) were excluded. Results: The primary analysis included 4721 deliveries with duration of ruptured membranes ≤ 24 h. After adjusting for other factors known to be associated with vertical transmission using logistic regression analysis to assess the strength of the relationship, the risk of vertical HIV transmission increased approximately 2% with an increase of 1 h in the duration of ruptured membranes [adjusted odds ratio, 1.02; 95% confidence interval, 1.01-1.04; for each 1 h increment]. There were no significant interactions of duration of ruptured membranes with study cohort or with any of the covariates, except maternal AIDS. Among women diagnosed with AIDS, the estimated probability of transmission increased from 8% to 31% with duration of ruptured membranes of 2 h and 24 h respectively (P < 0.01). Conclusions: These results support the importance of duration of ruptured membranes as a risk factor for vertical transmission of HIV and suggest that a diagnosis of AIDS in the mother at the time of delivery may potentiate the effect of duration of ruptured membranes. © 2001 Lippincott Williams & Wilkins.

Published
2001

12. Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009

Author

Tariq, S, Townsend, Cl, Cortina Borja, M, Duong, T, Elford, J, Thorne, C, Tookey, Pa, Giaquinto, C, Rampon, O, Mazza, A, De Rossi, A, Grosch Wörner, I, Mok, J, de José MI, Larrú Martínez, B, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Anzén, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, De Maria, A, Mûr, A, Payà, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Rabusin, M, Bernardon, M, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, Chiara, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Masters, J, Haile Selassie, H, French, C, Shakes, I., National Study of HIV in Pregnancy Childhood, National Study of HIV in Pregnancy, Childhood, Martinelli, Pasquale, Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, Obstetrics and Gynaecology, Tariq, S, Townsend, Cl, Cortina Borja, M, Duong, T, Elford, J, Thorne, C, Tookey, Pa, European Collaborative, Study, Giaquinto C, National Study of HIV in Pregnancy C. h. i. l. d. h. o. o. d., Rampon, O, Mazza, A, De Rossi, A, Grosch Wörner, I, Mok, J, de José, Mi, Larrú Martínez, B, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Anzén, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, De Maria, A, Mûr, A, Payà, A, López Vilchez, Ma, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Rabusin, M, Bernardon, M, Buffolano, Wilma, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Masters, J, Haile Selassie, H, French, C, and Shakes, I.

Subjects
Adult, Pediatrics, medicine.medical_specialty, Time Factors, HAART, Anti-HIV Agents, HIV Infections, antiretroviral agents, highly active antiretroviral therapy, HIV, pregnancy outcome, viral load, congenital abnormalities, Article, Zidovudine, ANTIRETROVIRAL AGENTS, immune system diseases, Hiv infected, Antiretroviral Therapy, Highly Active, Medicine, Humans, Pharmacology (medical), Pregnancy Complications, Infectious, antiretroviral agents, highly active antiretroviral therapy, HIV, pregnancy outcome, viral load, Pregnancy outcomes, Retrospective Studies, Pregnancy, integumentary system, business.industry, Infant, virus diseases, Retrospective cohort study, medicine.disease, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, zidovudine, Europe, Infectious Diseases, In utero, Immunology, Female, pregnancy, business, Viral load, medicine.drug
Abstract

Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing highly active antiretroviral therapy (HAART) in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission (MTCT) of HIV, and congenital abnormality. This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AORs). Overall, 15.8% (1199 of 7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (P

Published
2011

14. Increased CD40/CD154 T cell costimulation in uninfected infants born to HIV–positive mothers subjected to antiretroviral therapy

Author

Romano Simona, Avellino R, TOMEI, ELVIRA, Buffolano W, Bisogni Rita, Russo R., Carandente Giarrusso P., Romano Maria Fiammetta., Romano Simona, Avellino R, Tomei L, Buffolano W, Bisogni R, Russo R, Carandente Giarrusso P, Romano MF., Romano, Simona, Avellino, R, Tomei, Elvira, Buffolano, W, Bisogni, Rita, Russo, R., Carandente Giarrusso, P., and Romano Maria, Fiammetta.

Published
2004

16. Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period

Author

Chiappini E, Galli L, Tovo PA, Gabiano C, Lisi C, Giacomet V, Bernardi S, Esposito S, Rosso R, Giaquinto C, Badolato R, GUARINO, ALFREDO, Maccabruni A, Masi M, Cellini M, Salvini F, Di Bari C, Dedoni M, Dodi I, de Martino M, Osimani P, Cordiali R., Larovere D, De Serio G, Giannini AM, Quercia M., Ruggeri M., Miniaci A, Specchia F, Ciccia M, Faldella G, Baldi F, Lanari M. Ciccia M, Bertulli C, Sorlini A, Ricci F, Dessy C, Pintor M, Fenu ML, Cavallini R, Aliffi A, Anastasio E, Aloe M., Abbagnato L., Merlino S, Fiumana E, Burnelli R, Bonsignori F, Gervaso P, Sollai S., Viscoli C, Cosso D, Timitilli A, Amoretti M., Vigano` A, Zuccotti GV, Mameli C, Fabiano V, Coletto S, Nello F, Riva E, Bettiga C, Picciolli, Irene, Preti Valentina, Tagliaferri Laura, Lipreri R, Mancini L., Mariotti I, Manzotti E, Giubbarelli F., GIANNATTASIO, ANTONIETTA, LO VECCHIO, ANDREA, BRUZZESE, EUGENIA, Tarallo L, Buffolano W., Pennazzato M, Rampon O., Dalle Nogare ER, Sanfilippo A, Romano A, Saitta M, Bandello MA, Tchana I, Maccabruni A., Felici L., Verrotti M., Consolini R, Palla G, Magnani C., Palma P, Pontrelli G, Tchidjou K. H, Genovese O, Falconieri P, Casadei M, Valentini P, Casadei, Martino, Anzidei, Cerilli, Catania Ajissa, Castelli Gattinara G., Cristiano R, Labalestra G, Portelli V., Mazza A, Chiarello P, Garazzino S, Mignone F, Calitri C., Rabusin M, Verzegnassi F., Pellegatta A., Boscardini L, Fortunati P, Da Riol R., Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giacomet, V, Bernardi, S, Esposito, S, Rosso, R, Giaquinto, C, Badolato, R, Guarino, Alfredo, Maccabruni, A, Masi, M, Cellini, M, Salvini, F, Di Bari, C, Dedoni, M, Dodi, I, de Martino, M, Osimani, P, Cordiali, R., Larovere, D, De Serio, G, Giannini, Am, Quercia, M., Ruggeri, M., Miniaci, A, Specchia, F, Ciccia, M, Faldella, G, Baldi, F, Lanari M., Ciccia M, Bertulli, C, Sorlini, A, Ricci, F, Dessy, C, Pintor, M, Fenu, Ml, Cavallini, R, Aliffi, A, Anastasio, E, Aloe, M., Abbagnato, L., Merlino, S, Fiumana, E, Burnelli, R, Bonsignori, F, Gervaso, P, Sollai, S., Viscoli, C, Cosso, D, Timitilli, A, Amoretti, M., Vigano`, A, Zuccotti, Gv, Mameli, C, Fabiano, V, Coletto, S, Nello, F, Riva, E, Bettiga, C, Picciolli, Irene, Preti, Valentina, Tagliaferri, Laura, Lipreri, R, Mancini, L., Mariotti, I, Manzotti, E, Giubbarelli, F., Giannattasio, Antonietta, LO VECCHIO, Andrea, Bruzzese, Eugenia, Tarallo, L, Buffolano, W., Pennazzato, M, Rampon, O., Dalle Nogare, Er, Sanfilippo, A, Romano, A, Saitta, M, Bandello, Ma, Tchana, I, Maccabruni, A., Felici, L., Verrotti, M., Consolini, R, Palla, G, Magnani, C., Palma, P, Pontrelli, G, Tchidjou, K. H., Genovese, O, Falconieri, P, Casadei, M, Valentini, P, Casadei, Martino, Anzidei, Cerilli, Catania, Ajissa, Castelli Gattinara, G., Cristiano, R, Labalestra, G, Portelli, V., Mazza, A, Chiarello, P, Garazzino, S, Mignone, F, Calitri, C., Rabusin, M, Verzegnassi, F., Pellegatta, A., Boscardini, L, Fortunati, P, and Da Riol, R.

Abstract

BACKGROUND: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown. METHODS: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis. RESULTS: Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p < 0.0001). Significant change in the use of each antiretroviral drug occurred over the time periods (p < 0.0001). Factors independently associated with virological and immunological success were as follows: later calendar periods, younger age at regimen (only for virological success) and higher CD4(+) T-lymphocyte percentage at baseline. Use of unboosted PI was associated with lower adjusted hazard ratio (aHR) of virological or immunological success with respect to NNRTI- and boosted PI-based regimens, with no difference among these two latter types. CONCLUSION: Use of new generation antiretroviral drugs in Italian HIV-infected children is increasing. No different viro-immunological outcomes between NNRTI- and boosted PI-based cART were observed

Published
2012

17. Prenatal diagnosis of congenital rubella infection and ultrasonography: a preliminary study

Author

Migliucci A, Di Fraja D, Laura Sarno, Acampora E, Ll, Mazzarelli, Quaglia F, Mallia Milanes G, Buffolano W, Napolitano R, Simioli S, Gm, Maruotti, Martinelli P, Migliucci, A, Di Fraja, D, Sarno, Laura, Acampora, E, Mazzarelli, Ll, Quaglia, F, Mallia Milanes, G, Buffolano, W, Napolitano, R, Simioli, S, Maruotti, Gm, and Martinelli, Pasquale

Subjects
Pregnancy, Rubella Syndrome, Congenital, Humans, Female, Pregnancy Complications, Infectious, Rubella, Ultrasonography, Prenatal, Retrospective Studies
Abstract

The aim of this study was to analyze the role of ultrasonography in the prenatal diagnosis of women with confirmed rubella infection in pregnancy.We performed a retrospective, population-based study on 175 women referred to our Centre of Infectious Disease in Pregnancy of AOU Federico II for rubella infection, in the period between January 1999 and December 2009. In confirmed cases of infection we performed periodic ultrasonographic assessment of fetal anatomy looking for prenatal findings of rubeovirus infection. Neonatal outcomes were collected.Among 175 women, 48 (27.4%) were confirmed cases, in 83 (47.4%) cases rubella infection remain suspected. The remaining 44 (25.1%) women were excluded to having rubella infection in pregnancy. No defined probable cases were found. Among children born to mother with confirmed rubella infection, 9 (18.7%) resulted infected by rubella virus. In particular 6 newborns (66% of the affected) were asymptomatic, two babies showed incomplete congenital rubella syndrome (CRS), due to the presence of deafness in the absence of other congenital abnormalities without showing any USG findings. Only one baby showed a complete CRS: USG prenatal rubella infection findings were IUGR, polydramnios, cardiomegaly, defects of atrial septum, hepatosplenomegaly, ascites, echogenic bowel, placentomegaly. USG specificity and sensitivity was 100% and 11% respectively.USG has an important role in the detection rubella intrauterine infection in case of severe abnormalities. The obstetricians should understand the limitations of ultrasound in detection of deafness and minor abnormalities.

Published
2011

18. Combination antiretroviral therapy and duration of pregnancy

Author

Aebi, C, Battegay, M, Bernasconi, E, Biedermann, K, Cheseaux, JJ, Drack, G, Erb, P, Flepp, M, Francioli, P, Furrer, HJ, Gianinazzi, MP, Gyr, T, Hirschel, B, Hosli, I, Hug, I, Irion, O, Keller, K, Kind, C, Laubereau, B, Lauper, U, Lorenzi, P, Matter, L, Nadal, D, Perrin, L, Rickenbach, M, Rudin, C, Schreyer, A, Schupbach, J, Telenti, A, Vernazza, P, Wolf, K, Wunder, D, Wyler, CA, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Seel, K, Schafer, A, Mok, J, Johnstone, F, Jimenez, J, Garcia-Rodriguez, MC, Bates, I, de Jose, I, Hawkins, F, de Gevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Lidman, K, Christensson, B, Levy, J, Hainaut, M, Peltier, A, Barlow, P, Wibaut, S, Lecroart, MC, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Martinez-Gomez, P, Carreras, R, Coll, O, Fortuny-Guasch C, Boguna, J, Caro, MC, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, De Santis, M, Semprini, AE, Savasi, V, Vigano, A, Probizer, FR, Maccabruni, A, Bucceri, A, Rancilio, L, Taylor, GP, Lyall, H, Penn, Z, Valerius, NH, Martinelli, P, Buffolano, W, Sansone, M, Tibaldi, C, Ziarati, N, Benedetto, C, Niemiec, T, Horban, A, Newell M.-L., Aebi C., Battegay M., Bernasconi E., Biedermann K., Cheseaux J.-J., Drack G., Erb P., Flepp M., Francioli P., Furrer H.J., Gianinazzi M.-P., Gyr T., Hirschel B., Hosli I., Hug I., Irion O., Keller K., Kind C., Laubereau B., Lauper U., Lorenzi P., Matter L., Naddal D., Perrin L., Rickenbach M., Rudin C., Schreyer A., Schupbach J., Telenti A., Vernazza P., Wolf K., Wunder D., Wyler C.-A., Giaquinto C., Ruga E., De Rossi A., Grosh-Worner I., Seel K., Schafer A., Mok J., Johnstone F., Jimenez J., Garcia-Rodriguez M.C., Bates I., De Jose I., Hawkins F., Ladron de Gevara C., Ma Pena J., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Perez-Tamarit D., Ridaura S., Gregori P., De la Torre R., Scherpbier H., Kreyenbroek M., Boer K., Bohlin A.B., Lindgren S., Ehrnst A., Belfrage E., Lidman K., Christensson B., Levy J., Hainaut M., Peltier A., Barlow P., Wibaut S., Lecroart M.C., Ferrazin A., Bassetti D., De Maria A., Gotta C., Mur A., Paya A., Vinolas M., Lopez-Vilchez M.A., Martinez-Gomez P., Carreras R., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Duse M., Scaravelli G., Stegagno M., De Santis M., and Semprini A.E.

Subjects
Epidemiology, HIV Infections, Substance Abuse, Intravenou, Cohort Studies, Pregnancy, Immunology and Allergy, Medicine, HIV Infection, Prospective Studies, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, Prospective cohort study, Obstetrics, Infectious, Substance Abuse, Pregnancy Outcome, Gestational age, Viral Load, Antiretroviral therapy, Reverse Transcriptase Inhibitor, Infectious Diseases, Combination, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, Intravenous, Prematurity, Delivery, Zidovudine, Viral load, Infant, Premature, Human, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Combination therapy, Anti-HIV Agents, Immunology, CD4 Lymphocyte Count, Delivery, Obstetric, Gestational Age, HIV-1, Humans, Infant, Newborn, Drug Therapy, antiretroviral therapy, combination therapy, epidemiology, pregnancy, prematurity, Premature, business.industry, Infant, Anti-HIV Agent, Obstetric, Odds ratio, Newborn, medicine.disease, Surgery, Pregnancy Complications, Prospective Studie, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objective: 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 (3015 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 2.60 195% confidence interval (CI), 1.43-4.751 and 1.82 (95% CI, 1.13-2.92) for infants exposed to combination therapy with and without a Pl, 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% CI, 1.03-4.58). 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. © 2000 Lippincott Williams & Wilkins.

Published
2000

19. The management of HCV infected pregnant women and their children European paediatric HCV network

Author

Pembrey, Lucy, Newell, Marie Louise, Tovo, Pier Angelo, Amoroso, A., Bevilaqua, E., Asensi Botet, F., Pereda, A., Balossini, V., Bona, G., Zaffaroni, M., Bandelloni, A., Coscia, A., Fabris, C., Aime, S., Belloni, C., Bossi, G., Salati, B., Boucher, C., Buffolano, W., Butler, K., Roura, L. Cabero, Sanges, J. M. Bertran, Cigna, P., Ciria, L. M., Ginard, C. Servera, Teruel, G. Claret, Fortuny, C., Coll, O., Corrias, A., Ledda, R., Floris, S., De Maria, A., Echeverria, J., Cilla, G., LANARI, MARCELLO, Tridapalli, E., Venturi, V., Fischler, B., Bohlin, A. B., Lindgren, S., Lindh, G., Giacomet, V., Merlo, M., Figini, C., Erba, P., Viganò, A., Hannam, S., Mieli Vergani, G., Hatzakis, A., Inchley, C., Fjaerli, H. O., Maccabruni, A., Marcellini, M., Sartorelli, M. R., Fontelos, P. Martin, Mazza, A., Mok, J. Y. Q., Mûr, A., Viñolas, M., Paternoster, D. M., Grella, P., Polywka, S., Quinti, I., Casadei, A. M., Rojahn, A., Berg, A., Rosso, R., Ferrando, S., Bassetti, D., Contreras, J. Ruiz, Manzanares, A., Extremera, A. Ruiz, Salvini, F., Zuccotti, G. V., Schmitz, T., Grosch Wörner, I., Sperling, C. Feiterna, Piening, T., Vegnente, A., Iorio, R., Versace, A., Lazier, L., Palomba, E., Gabiano, C., Balbo, L., Zanetti, A., Tanzi, E., FALDELLA, GIACOMO, Pembrey, L., Newell, M. L., Tovo, P. A., Amoroso, A., Bevilacqua, E., Asensi Botet, F., Pereda, A., Balossini, V., Bona, G., Zaffaroni, M., Bandelloni, A., Coscia, A., Fabris, C., Iorio, Raffaele, Vegnente, Angela, Pembrey, Lucy, Newell, Marie-Louise, Tovo, Pier-Angelo, Bevilaqua, E., Asensi-Botet, F., Aime, S., Belloni, C., Bossi, G., Salati, B., Boucher, C., Buffolano, W., Butler, K., Roura, L. Cabero, Sanges, J.M. Bertran, Cigna, P., Ciria, L.M., Ginard, C. Servera, Teruel, G. Claret, Fortuny, C., Coll, O., Corrias, A., Ledda, R., Floris, S., De Maria, A., Echeverria, J., Cilla, G., Faldella, Giacomo, Lanari, M., Tridapalli, E., Venturi, V., Fischler, B., Bohlin, A.-B., Lindgren, S., Lindh, G., Giacomet, V., Merlo, M., Figini, C., Erba, P., Viganò, A., Hannam, S., Mieli-Vergani, G., Hatzakis, A., Inchley, C., Fjaerli, H.O., Maccabruni, A., Marcellini, M., Sartorelli, M.R., Fontelos, P. Martin, Mazza, A., Mok, J.Y.Q., Mûr, A., Viñolas, M., Paternoster, D.M., Grella, P., Polywka, S., Quinti, I., Casadei, A.M., Rojahn, A., Berg, A., Rosso, R., Ferrando, S., Bassetti, D., Contreras, J. Ruiz, Manzanares, A., Extremera, A. Ruiz, Salvini, F., Zuccotti, G.V., Schmitz, T., Grosch-Wörner, I., Sperling, C. Feiterna, Piening, T., Vegnente, A., Iorio, R., Versace, A., Lazier, L., Palomba, E., Gabiano, C., Balbo, L., Zanetti, A., and Tanzi, E.

Subjects
Pediatrics, medicine.medical_specialty, Psychological intervention, Breastfeeding, Pregnancy, Prenatal Diagnosis, Diagnosis, medicine, Humans, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, Hepatitis C, Clinical management, Mother-to-child transmission, Paediatric, Follow-up, Hepatology, business.industry, Transmission (medicine), Gastroenterology, Infant, Newborn, virus diseases, Evidence-based medicine, medicine.disease, digestive system diseases, Infectious Disease Transmission, Vertical, Europe, Immunology, Female, Viral disease, business, Diagnosi
Abstract

Background/Aims: As evidence accumulates relating to mother-to-child (vertical) transmission of hepatitis C virus (HCV), it is timely to draw up guidelines for the clinical management of HCV infected pregnant women and their children. Methods: A review of evidence from the European Paediatric HCV Network (EPHN) prospective study of HCV infected women and their children and other published studies. Meeting of EPHN clinical experts to reach a consensus on recommendations for management. Each recommendation was graded according to the level of evidence. Results/conclusions: Although several risk factors for mother-to-child transmission have been identified, none are modifiable and there are currently no interventions available to prevent vertical transmission of HCV. Data on timing of loss of maternal antibodies and reliability of diagnostic tests inform the optimum follow-up schedule for confirmation or exclusion of infection in children born to HCV infected women. Based on the current evidence, routine antenatal screening for HCV should not be introduced and neither elective caesarean section nor avoidance of breastfeeding should be recommended to HCV infected women to prevent mother-to-child transmission of HCV. HCV/HIV co-infected women should follow existing HIV guidelines. © 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Published
2005

20. Determinants of mother-to-infant human immunodeficiency virus 1 transmission before and after the introduction of zidovudine prophylaxis

Author

de Martino, M, Galli, L, Tovo, PA, Gabiano, C, Pezzotti, P, Wagner, TM, Rezza, G, Osimani, P, De Mattia, D, Di Bari, C, Ruggeri, M, Baldi, F, Ciccia, M, Lanari, M, Masi, M, Venturi, V, Battisti, L, Duse, M, Chiriaco, PG, Cavallini, R, Dessi, C, Pintor, C, Anastasio, E, SABATINO, GIOVANNI, Sticca, M, Pomero, G, Bezzi, T, Chiappini, E, De Luca, M, Gervaso, P, Cecchi, MT, Bassetti, D, Gotta, C, Rosso, R, Timitilli, A, Tondo, U, Mussini, P, Bricalli, D, BUCCERI, ANDREA, Ferraris, G, Giovannini, M, Mosca, F, Lipreri, R, Guarino, A, Plebani, A, Riva, E, RIVA, SILVIA, Vigano, A, Zuccotti, GV, Cellini, M, Buffolano, W, Tarallo, L, D'Elia, R, Giaquinto, C, Rampon, O, Dalle Nogare, ER, Romano, A, Caselli, D, Maccabruni, A, Consolini, R, Benaglia, G, Magnani, C, Anzidei, G, Pistilli, AMC, Gattinara, GC, Catania, S, Facente, C, Falconieri, P, Fundaro, C, Genovese, O, Rendeli, C, Bionda, S, Cristiano, L, Garetto, S, Riva, C, PALOMBA, ERIKA, Portelli, V, Mazza, A, SALVATORE, CLAUDIO, Pellegatta, A, Molesini, M, de Martino, M, Galli, L, Tovo, PA, Gabiano, C, Pezzotti, P, Wagner, TM, Rezza, G, Osimani, P, De Mattia, D, Di Bari, C, Ruggeri, M, Baldi, F, Ciccia, M, Lanari, M, Masi, M, Venturi, V, Battisti, L, Duse, M, Chiriaco, PG, Cavallini, R, Dessi, C, Pintor, C, Anastasio, E, Sabatino, G, Sticca, M, Pomero, G, Bezzi, T, Chiappini, E, De Luca, M, Gervaso, P, Cecchi, MT, Bassetti, D, Gotta, C, Rosso, R, Timitilli, A, Tondo, U, Mussini, P, Bricalli, D, Bucceri, A, Ferraris, G, Giovannini, M, Mosca, F, Lipreri, R, Guarino, A, Plebani, A, Riva, E, Riva, S, Vigano, A, Zuccotti, GV, Cellini, M, Buffolano, W, Tarallo, L, D'Elia, R, Giaquinto, C, Rampon, O, Dalle Nogare, ER, Romano, A, Caselli, D, Maccabruni, A, Consolini, R, Benaglia, G, Magnani, C, Anzidei, G, Pistilli, AMC, Gattinara, GC, Catania, S, Facente, C, Falconieri, P, Fundaro, C, Genovese, O, Rendeli, C, Bionda, S, Cristiano, L, Garetto, S, Riva, C, Palomba, E, Portelli, V, Mazza, A, Salvatore, C, Pellegatta, A, and Molesini, M

Subjects
immunodeficiency virus 1
Abstract

Background: Randomized controlled trials have demonstrated that zidovudine therapy decreases the mother-to-infant transmission of human immunodeficiency virus 1 (HIV-1). Data from large observational studies may provide further important findings on the effectiveness at the population level of combined treatments in decreasing transmission.Objective: To evaluate time trends in prophylactic interventions and the determinants of transmission both before and after the introduction of antiretroviral prophylaxis, and in treated and untreated mother-infant pairs after 1995.Design and Setting: Analysis of prospective data on 3770 children born to HIV-1-infected women between 1985 and 1999 and reported to the Italian Register for HIV Infection in Children.Main Outcome Measures: Logistic regression random effects models were used to estimate crude and adjusted odds ratios for several factors potentially influencing vertical transmission for 2periods-1985 through 1995 (January 1, 1985, through December 31,1995) and 1996 through 1999 (January 1, 1996, through December 31, 1999), and between treated and untreated children after 1995.Results: The transmission rate was 15.5% in the 19851995 period and 5.8% in the 1996-1999 period. By 1999, prophylactic interventions had greatly increased. Antiretroviral treatment (ART) usage was 89.9%, (55.1% combination ART) and the elective cesarean delivery rate was 81.3%. In multivariate analysis, only elective cesarean delivery was associated with a lower risk of mother-to-infant transmission before 1995. After 1995, nonbreastfeeding and receipt of ART were protective whereas elective cesarean delivery was not significantly protective in multivariate analysis. Transmission risk was reduced by 76% with an incomplete zidovudine regimen, 88% with a complete regimen, and 93% when the mother received combination ART. In the 1996-1999 period, the transmission rate for nonbreastfeeding mother-infant pairs was 8.6% with elective cesarean delivery, 4.4% with any ART, and 2.4% with these interventions combined.Conclusion: Prophylactic interventions, and in particular ART, reduced perinatal HIV-1 transmission at a population level in Italy.

Published
2004

21. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, GREGORI, PIETRO, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, LEVY, JOHANNA, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, DE MARIA, ANTONELLA, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, PEREZ, JESUS MARIA, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, BRAMBILLA, TERESA, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, Perez, JM, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, Brambilla, T, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, and Marczynska, M

Subjects
Europe, antiretroviral therapy, HIV, uninfected children, abnormalities
Abstract

Concerns have been raised over possible adverse effects of prophylactic antiretroviral therapy (ART) on the fetus and newborn. We analyzed data relating to uninfected children enrolled in the European Collaborative Study and investigated the association between ART exposure, perinatal problems, and major adverse health events later in life. Median length of follow-up was 2.2 (0-15.9) years. Of the 2414 uninfected children, 687 (28%) were exposed to ART in all three periods (antenatal, intrapartum, and neonatal). Of the 1008 infants exposed to ART at any time, 906 (90%) were exposed antenatally, 840 (83%) neonatally, and 750 (74%) both antenatally and neonatally. ART exposure was not significantly associated with pattern or prevalence of congenital abnormalities or low birth weight. In multivariate analysis, prematurity was associated with exposure to combination therapy without a protease inhibitor (PI) (OR = 2.66; 95% CI: 1.52-4.67) and with a PI (OR = 4.14; 95% CI: 2.36-7.23). ART exposure was associated with anemia in early life (P < .001). There was no evidence of an association with clinical manifestations suggestive of mitochondrial abnormalities. The absence of serious adverse events in this large cohort of uninfected children exposed to prophylactic ART in the short to medium term is reassuring.

Published
2004

22. Missed opportunities among HIV-positive women to control viral replication during pregnancy and to have a vaginal delivery

Author

Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Thorne, C, European Collaborative Study in EuroCoord, Swiss, Mother, Child HIV Cohort Study Collaborators: Thorne, C, Bailey, H, Giaquinto, C, Rampon, O, Mazza, A, De Rossi, A, Wörner, I, Mok, J, de José MI, Martínez, B, Peña, J, Garcia, J, Lopez, Jr, Rodriguez, Mc, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Payà, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, J, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Maso, G, Tropea, M, Barresi, V, Taylor, G, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, Chiara, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Aubert, V, Barth, J, Battegay, M, Bernasconi, E, Böni, J, Brazzola, P, Bucher, Hc, Burton Jeangros, C, Calmy, A, Cavassini, M, Cheseaux, Jj, Drack, G, Duppenthaler, A, Egger, M, Elzi, L, Fellay, J, Francini, K, Furrer, H, Fux, Ca, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, Hh, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kovari, H, Ledergerber, B, Martinetti, G, de Tejada, B, Metzner, K, Müller, N, Nadal, D, Pantaleo, G, Polli, Ch, Posfay Barbe, K, Rauch, A, Regenass, S, Schmid, P, Schultze, D, Schöni Affolter, F, Schüpbach, J, Speck, R, Taffé, P, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Wyler, Ca, Yerly, S., Posfay Barbe, Klara, Wyler, Claire-Anne, University of Zurich, Aebi-Popp, Karoline, Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Buffolano, Wilma, Thorne, C, European Collaborative Study in, Eurocoord, Swiss, Mother, and Child HIV Cohort, S. t. u. d. y.

Subjects
mode of delivery, medicine.medical_treatment, HIV Infections, Delivery, Obstetric/statistics & numerical data, Virus Replication, 10234 Clinic for Infectious Diseases, Cohort Studies, HIV Infections/drug therapy/prevention & control/transmission, Pregnancy, Antiretroviral Therapy, Highly Active, 2736 Pharmacology (medical), Pharmacology (medical), Surgical Procedures, Elective/statistics & numerical data, Pregnancy Complications, Infectious, Europe, HIV, Mode of delivery, Adult, Anti-HIV Agents, Cesarean Section, Delivery, Obstetric, Drug Therapy, Combination, Elective Surgical Procedures, Female, Guidelines as Topic, Health Policy, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Viral Load, Infectious Diseases, ddc:618, Obstetrics, Vaginal delivery, Transmission (medicine), Cesarean Section/statistics & numerical data, Meta-analysis, provvedimento amministrativo - nullità - domanda riconvenzionale, Viral load, Cohort study, medicine.medical_specialty, Pregnancy Complications, Infectious/drug therapy/epidemiology/prevention & control, 610 Medicine & health, Europe/epidemiology, Pharmacotherapy, medicine, Caesarean section, business.industry, 2725 Infectious Diseases, medicine.disease, Viral Load/drug effects, HIV, pregnancy, mode of delivery, Anti-HIV Agents/therapeutic use, Settore MED/40 - Ginecologia e Ostetricia, business, Infectious Disease Transmission, Vertical/prevention & control/statistics & numerical data
Abstract

INTRODUCTION: Most national guidelines for the prevention of mother-to-child transmission of HIV in Europe updated between 2001 and 2010 recommend vaginal deliveries for women with undetectable or very low viral load (VL). Our aim was to explore the impact of these new guidelines on the rates of vaginal deliveries among HIV-positive women in Europe. METHODS: In a pooled analysis of data on HIV-positive pregnant women enrolled in the Swiss Mother & Child HIV Cohort Study and the European Collaborative Study 2000 to 2010, deliveries were classified as occurring pre- or postpublication of national guidelines recommending vaginal delivery. RESULTS: Overall, 2663 women with 3013 deliveries were included from 10 countries; 28% women were diagnosed with HIV during pregnancy. Combination antiretroviral therapy was used in most pregnancies (2020, 73%), starting during the first or second trimester in 78% and during the third trimester in 22%; in 25% pregnancies, the woman conceived on combination antiretroviral therapy. Overall, in 86% pregnancies, a VL < 400 copies per milliliter was achieved before delivery. The proportion of vaginal deliveries increased from 17% (414/2377) before the change in guidelines to 52% (313/600) after; elective Caesarean section rates decreased from 65% to 27%. The proportion of women with undetectable VL having a Caesarean section was 55% after implementation of new guidelines. We observed a decrease of late preterm deliveries from 16% (377/2354) before to 7% (42/599) after the change in guidelines (P < 0.001). CONCLUSION: There are still missed opportunities for women with HIV to fully suppress their VL and to deliver vaginally in Europe.

Published
2013

23. Insufficient antiretroviral therapy in pregnancy: missed opportunities for prevention of mother-to-child transmission of HIV in Europe

Author

Bayley, H, Townsend, C, Cortina Borja, M, Thorne, C, Newell, Ml, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Grosch Wörner, I, Mok, J, de José MI, Larrú Martínez, B, Ma Peña, J, Gonzalez Garcia, J, Arribas Lopez JR, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Belfrage, E, Lindgren, S, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Pàya, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., European Collaborative Study in, Eurocoord, Buffolano, Wilma, Bailey, H, Townsend, C, Cortina Borja, M, Thorne, C., European Collaborative, Study, Martinelli, Pasquale, AII - Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, and Obstetrics and Gynaecology

Subjects
Adult, medicine.medical_specialty, Acquired Immunodeficiency Syndrome, HIV, Pregnancy, Antiviral Agents, antiretroviral therapy, Human immunodeficiency virus (HIV), HIV-1 infected women, mother-to-child transmission, risk factors, HIV Infections, medicine.disease_cause, Medical care, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Antiretroviral Therapy, Highly Active, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Disengagement theory, Pregnancy Complications, Infectious, Pharmacology, 030219 obstetrics & reproductive medicine, business.industry, mother-to-child transmission, Prevention of mother to child transmission, medicine.disease, Antiretroviral therapy, Infectious Disease Transmission, Vertical, 3. Good health, Europe, Infectious Diseases, Family medicine, Immunology, HIV-1, Female, business, HIV-1 infected women, Viral load
Abstract

Background Although mother-to-child transmission (MTCT) rates are at an all-time low in Western Europe, potentially preventable transmissions continue to occur. Duration of antenatal combination antiretroviral therapy (ART) is strongly associated with MTCT risk. Methods Data on pregnant HIV-infected women enrolled in the Western and Central European sites of the European Collaborative Study between January 2000 and July 2009 were analysed. The proportion of women receiving no antenatal ART or 1–13 days of treatment was investigated, and associated factors explored using logistic regression models. Results Of 2,148 women, 142 (7%) received no antenatal ART, decreasing from 8% in 2000–2003 to 5% in 2004– 2009 (χ2=8.73; PConclusions Over the last 10 years, around one in 11 women in this study received insufficient antenatal ART, accounting for 40% of MTCTs. One-half of these women were diagnosed before conception, suggesting disengagement from care.

Published
2011

24. Sources of toxoplasma infection in pregnant women: European multicentre case-control study

Author

Cook, A J C, Gilbert, R E., Buffolano, W, Zufferey, J, Petersen, E, Jenum, P A., Foulon, W, Semprini, A E., and Dunn, D T.

Subjects
Toxoplasmosis -- Risk factors, Pregnant women -- Diseases, Health, Diseases, Risk factors
Abstract

Abstract Objective To determine the odds ratio and population attributable fraction associated with food and environmental risk factors for acute toxoplasmosis in pregnancy. Design Case-control study. Setting Six large European [...]

Published
2000

25. Mode of delivery in HIV-infected pregnant women and prevention of mother-to-child transmission: changing practices in Western Europe

Author

Boer, K, England, K, Godfried, Mh, Thorne, C, Newell, Ml, Mahdavi, S, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Worner, Ig, Mok, J, DE JOSE MI, Martinez, Bl, Pena, Jm, Garcia, Jg, Lopez, Jra, Rodriguez, Mcg, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Scherpbier, Hj, Kreyenbroek, M, Nellen, Fjb, Naver, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, DE BRUYCKER JJ, Thiry, N, Waterloos, H, Viscoli, C, DE MARIA, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Savasi, V, Fiore, S, Crivelli, M, Vigano, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., Other Research, Obstetrics and Gynaecology, AII - Amsterdam institute for Infection and Immunity, General Internal Medicine, and Martinelli, Pasquale

Subjects
mode of delivery, HIV Infections, 0302 clinical medicine, prevention, Pregnancy, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Young adult, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, elective caesarean section, mode of delivery, mother-to-child transmission, prevention, 030219 obstetrics & reproductive medicine, pregnancy mother-to-child transmission, Vaginal delivery, Obstetrics, Health Policy, Prenatal Care, Viral Load, 3. Good health, Substance abuse, Europe, Infectious Diseases, Premature birth, Premature Birth, Reverse Transcriptase Inhibitors, Female, medicine.symptom, delivery, Viral load, Zidovudine, Adult, medicine.medical_specialty, elective caesarean section, Prenatal care, Article, 03 medical and health sciences, Young Adult, medicine, Humans, business.industry, Cesarean Section, mother-to-child transmission, HIV, Infant, Newborn, Infant, medicine.disease, Delivery, Obstetric, Infectious Disease Transmission, Vertical, Low birth weight, business, Epidemiologic Methods
Abstract

Objectives The aim of the study was to examine temporal and geographical patterns of mode of delivery in the European Collaborative Study (ECS), identify factors associated with elective caesarean section (CS) delivery in the highly active antiretroviral therapy (HAART) era and explore associations between mode of delivery and mother-to-child transmission (MTCT). Methods The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their infants prospectively followed. Data on 5238 mother-child pairs (MCPs) enrolled in Western European ECS sites between 1985 and 2007 were analysed. Results The elective CS rate increased from 16% in 1985-1993 to 67% in 1999-2001, declining to 51% by 2005-2007. In 2002-2004, 10% of infants were delivered vaginally, increasing to 34% by 2005-2007. During the HAART era, women in Belgium, the United Kingdom and the Netherlands were less likely to deliver by elective CS than those in Italy and Spain [adjusted odds ratio (AOR) 0.07; 95% confidence interval (CI) 0.04-0.12]. The MTCT rate in 2005-2007 was 1%. Among MCPs with maternal HIV RNA

Published
2010

26. Use of neonatal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV is decreasing in Western Europe

Author

England, K., Thorne, C., Giaquinto, C., Rampon, O., D’Elia, R., De Rossi, A., Grosch Wörner, I., Mok, J., de José, I., Laaru ́, A., Bates, I., Salas, A., Ma Peña, J., Gonzalez Garcia, J., Arribas Lo pez, J. R., Garcia Rodriguez, M. C., Asensi Botet, F., Otero, M. C., Pérez Tamarit, D., Scherpbier, H. J., Kreyenbroek, M., Godfried, M. H., Nellen, F. J. B., Boer, K., Bohlin, A. B., Lindgren, S., Anzén, B., Lidman, K., Elfgren, K., Gyllensten, K., Pehrson, P. O., Levy, J., Barlow, P., Manigart, Y., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., DE MARIA, Andrea, Bentivoglio, Giorgio, Ferrero, Simone, Gotta, C., Mur, A., Paya, A., López Vilchez, M. A., Carreras, R., Valerius, N. H., Rosenfeldt, V., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguña, J., Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., De Santis, M., Savasi, V., Fiore, S., Cri velli, M., Ferrazzi, E., Vigano`, A., Giacomet, V., Frasca, D., Zuccotti, G., Ravagni Probizer, F., Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Maruotti, G., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Marczynska, T. Niemiec ̧ M., Dobosz, S., Popielska, J., and Oldakowska, A.

Subjects
Microbiology (medical), Cart, Pediatrics, medicine.medical_specialty, antiretroviral therapy, HIV Infections, Chemoprevention, Article, Zidovudine, Pregnancy, Medicine, Humans, HIV, pregnancy, Maternal Transmission, business.industry, Infant, Newborn, medicine.disease, Infectious Disease Transmission, Vertical, Europe, Infectious Diseases, Chemoprophylaxis, Cohort, Observational study, Female, business, Viral load, medicine.drug
Abstract

To the Editor: Since the ACTG076 trial results were published in 1994 [1], antiretroviral prophylaxis for the neonate as well as during pregnancy and delivery has been the cornerstone of prevention of mother-to-child transmission (MTCT) of HIV. In the second decade of the combination antiretroviral therapy (cART) era, around 90% of pregnant HIV-infected women in Western Europe receive antenatal cART, for their own health and/or for prevention of MTCT (PMTCT) [2-4]. The rationale for including neonatal prophylaxis in the ACTG076 trial included uncertainty regarding timing of MTCT and the desire to boost the infant’s in utero and intrapartum antiretroviral drug exposure with 6 weeks zidovudine prophylaxis, as a post-exposure prophylaxis (PEP) for newborns not infected with HIV in utero. Observational studies and trials subsequently demonstrated effectiveness of neonatal PEP for infants whose mothers received no antiretroviral drugs [5-7]. No trial data exist comparing the efficacy of different neonatal prophylaxis regimens for infants of women on cART. We investigated trends in neonatal prophylaxis use in the cART era in Western European sites of the European Collaborative Study, a cohort of HIV-infected pregnant women and their children; full methods are described elsewhere [4]. Logistic regression was used to investigate factors associated with receipt of neonatal prophylaxis. Variables considered in the multivariable model were antenatal antiretroviral use, mode of delivery, country and year of delivery, prematurity (

Published
2009

28. Is the interruption of antiretroviral treatment during pregnancy an additional major risk factor for mother-to-child transmission of HIV type 1?

Author

Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, W, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, De Benedictis, F, Osimani, P, La Rovere, D, Quercia, M, Baldi, F, Ciccia, M, Faldella, A, Masi, M, Plebani, A, Spinelli, E, Dedoni, M, Gariel, D, Chiarello, P, Magnolia, Mg, Sticca, M, Vivalda, L, Bezzi, Teresa Maria, Fiumana, Elisa, Bianchi, L, Battiglia, N, Gervaso, P, Bondi, E, Cosso, D, Gotta, C, Ginocchio, L, Rosso, R, Viscoli, C, Amoretti, C, Esposito, S, Farina, F, Giacomet, V, Lipreri, R, Salvatici, E, Stucchi, S, Palazzi, G, Paolucci, P, De Luca, G, Giannattasio, A, Tancredi, F, Tarallo, L, Rampon, O, Dalle Nogare, E, Romano, A, Saitta, M, Mariani, B, Biver, P, Consolini, R, Palla, G, De Fanti, A, Dodi, I, Verna, M, Bove, G, Casadei, Am, Castelli Gattinara, G, Catania, S, Martino, Am, Sirufo, Mm, Ganau, A, Cristiano, L, Scolfaro, C, Versace, A, Portelli, V, Gentilini, L, Mazza, A, Bernardon, M, Bua, J, Rabusin, M, Pellegatta, A, Fortunati, P., Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, Wilma, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, and Italian Register for HIV Infection in, C. h. i. l. d. r. e. n.

Subjects
Microbiology (medical), antiretroviral treatment, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, HIV Infections, transmission mother-to-child, HIV infection, Cohort Studies, HIV, Italian Register for HIV Infection in Children, therapeutic use, Cohort Studies, Delivery, Obstetric, Female, HIV Infections, drug therapy/transmission, HIV-1, isolation /&/ purification, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious, drug therapy, Pregnancy Trimester, First, Pregnancy Trimester, Third, Prospective Studies, Risk Factors, Viral Load, Withholding Treatment, Pregnancy, Risk Factors, medicine, Elective Cesarean Delivery, Humans, Prospective Studies, Risk factor, Pregnancy Complications, Infectious, Maternal Transmission, Obstetrics, business.industry, Infant, Newborn, Viral Load, medicine.disease, Delivery, Obstetric, Confidence interval, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, Infectious Diseases, Withholding Treatment, Cohort, HIV-1, Gestation, Female, business, Viral load
Abstract

There is currently an experts' agreement discouraging interruption of antiretroviral treatment (ART) during the first trimester of pregnancy in women infected with human immunodeficiency virus type 1 (HIV-1). However, this recommendation is poorly supported by data. We evaluated the effects of discontinuing ART during pregnancy on the rate of mother-to-child transmission.Logistic regression models were performed in a prospective cohort of 937 children who were perinatally exposed to HIV-1 to estimate adjusted odds ratios for confounding factors on mother-to-child transmission, including maternal interruption of ART.Among 937 pregnant women infected with HIV-1, ART was interrupted in 81 (8.6%) in the first trimester and in 11 (1.2%) in the third trimester. In the first trimester, the median time at suspension of ART was 6 weeks (interquartile range [IQR], 5-6 weeks) and the time without treatment was 8 weeks (IQR, 7-11 weeks). In the third trimester, the median time at suspension of ART was 32 weeks (IQR, 23-36 weeks) and the time without treatment was 6 weeks (IQR, 2-9 weeks). The plasma viral load was similar in women who had treatment interrupted in the first trimester and in those who did not have treatment interrupted. Overall, the rate of mother-to-child transmission in the whole cohort was 1.3% (95% confidence interval [CI], 0.7%-2.3%), whereas it was 4.9% (95% CI, 1.9%-13.2%) when ART was interrupted in the first trimester and 18.2% (95% CI, 4.5%-72.7%) when ART was interrupted in the third trimester. In the multiple logistic regression models, only interruption of ART during either the first or the third trimester, maternal mono- or double therapy, delivery by a mode other than elective cesarean delivery, and a viral load at delivery4.78 log(10) copies/mL were independently associated with an increased rate of mother-to-child transmission.Discontinuing ART during pregnancy increases the rate of mother-to-child transmission of HIV-1, either when ART is stopped in the first trimester and subsequently restarted or when it is interrupted in the third trimester. This finding supports recommendations to continue ART in pregnant women who are already receiving treatment for their health.

Published
2009

30. The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West

Author

Giaquinto, C, Rampon, O, D'Elia, R, De Rossi, A, Grosch Worner, I, Feiterna Sperling, C, Schmitz, T, Casteleyn, S, Mok, J., de Jose, I, Bates, I, Larru, B, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Perez Tamarit, D, Suarez, G, Scherpbier, H, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Bohlin, Ab, Lindgren, S, Belfrage, E, Naver, L, Anzen, B, Lidman, K, Levy, J, Hainaut, M, Goetghebuer, T, Manigart, Y, Barlow, P, Ferrazin, A, Bassetti, D, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, Lopez Vilchez MA, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, Marzia, Scaravelli, G, Stegagno, M, De Santis, M, Savasi, V, Ferrazzi, E, Vigano, A, Giacomet, V, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Agangi, A, Tibaldi, C, and Marini, S.

Published
2006

33. Does exposure to antiretroviral therapy affect growth in the first 18 months of life in uninfected children born to HIV-infected women?

Author

Hankin, C, Bentivoglio, Giorgio, Newell, Ml, Giaquinto, C., Rampon, O., De Rossi, A., Grosch Worner, I., Mok, J., de Jose, I., Bates, I., Hawkins, F., Ladron de Guevara, C., Ma Peña, J., Gonzalez Garcia, J., Arribas Lopez, J. R., Garcia Rodriguez, M. C., Asensi Botet, F., Otero, M. C., Pérez Tamarit, D., Scherpbier, H., Kreyenbroek, M., le Poole, E., Boer, K., Bohlin, A. B., Lindgren, S., Belfrage, E., Navér, L., Anzén, B., Lidman, K., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., DE MARIA, Andrea, Gotta, C., Ferrero, Simone, Bentivoglio, G., Mur, A., Paya, A., López Vilchez, M. A., Carreras, R., Valerius, N. H., Buffolano, W., Tiseo, N., Martinelli, P., Sansone, M., Agangi, A., Niemiexc, T., Marczynska, M., Oldakowska, A., and Kaflik, M.

Subjects
antiretroviral therapy, HIV, uninfected children, pregnancy, Growth
Published
2005

35. A significant sex - but not elective cesarean section - Effect on; mother-to-child transmission of hepatitis C virus infection

Author

Tovo, PA, Pembrey, L, Newell, ML, Amoroso, A, Asensi-Botet, F, Pereda, A, Balossini, V, Bona, G, Zaffaroni, M, Bandelloni, A, Coscia, A, Fabris, C, Aime, S, Belloni, C, Bossi, G, Salati, B, Boucher, C, Buffolano, W, Butler, K, Roura, LC, Sanges, JMB, Cigna, P, Ciria, LM, Ginard, CS, Teruel, GC, Fortuny-Guasch C, Coll, O, Corrias, A, Ledda, R, Floris, S, De Maria, A, Echeverria, J, Cilla, G, Faldella, G, Lanari, M, Tridapalli, E, Venturi, V, Fischler, B, Bohlin, AB, Lindgren, S, Lindh, G, Giacomet, V, Merlo, M, Figini, C, Erba, P, Vigano, A, Hannam, S, Mieli-Vergani, G, Hatzakis, A, Inchley, C, Fjaerli, HO, Maccabruni, A, Marcellini, M, Sartorelli, MR, Fontelos, PM, Mazza, A, Mok, JYQ, Mur, A, Vinolas, M, Paternoster, DM, Grella, P, Polywka, S, Quinti, I, Casadei, AM, Rojahn, A, Berg, A, Rosso, R, Ferrando, S, Bassetti, D, Contreras, JR, Manzanares, A, Extremera, AR, Salvini, F, Zuccotti, GV, Schmitz, T, Grosch-Worner, I, Sperling, CF, Piening, T, Vegnente, A, Iorio, R, Versace, A, Garetto, S, Lazier, L, Bressio, S, Riva, C, Alfarano, A, Wejstal, R, Norkrans, G, Zanetti, A, Tanzi, E, and European Paediat Hepatitis C Virus

Published
2005

38. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy

Author

Giaquinto, Carlo, Ruga, EZIA MARIA, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE, I, Bates, I, Hawkins, F, DE GUEVARA CL, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ MC, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT DP, Suarez, G, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, Ab, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Lidman, K, Anzen, B, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Goetghebuer, T, Ferrazin, A, Bassetti, D, DE MARIA, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, LOPEZ VILCHEZ MA, Rovira, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Caro, Mc, Canet, Y, Savasi, V, Vigano, A, Ferrazi, E, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Agangi, A, Sansone, M, Tibaldi, C, and Et, Al

Subjects
PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, RNA LEVELS, VERTICAL TRANSMISSION, CESAREAN DELIVERY, PREGNANT-WOMEN, PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, CESAREAN DELIVERY, RNA LEVELS, VERTICAL TRANSMISSION, PREGNANT-WOMEN
Published
2005

39. The management of HCV infected pregnant women and their children European paediatric HCV network

Author

Pembrey, L. Newell, M.-L. Tovo, P.-A. Amoroso, A. Bevilaqua, E. Asensi-Botet, F. Pereda, A. Balossini, V. Bona, G. Zaffaroni, M. Bandelloni, A. Coscia, A. Fabris, C. Aime, S. Belloni, C. Bossi, G. Salati, B. Boucher, C. Buffolano, W. Butler, K. Roura, L.C. Sanges, J.M.B. Cigna, P. Ciria, L.M. Ginard, C.S. Teruel, G.C. Fortuny, C. Coll, O. Corrias, A. Ledda, R. Floris, S. De Maria, A. Echeverria, J. Cilla, G. Faldella, G. Lanari, M. Tridapalli, E. Venturi, V. Fischler, B. Bohlin, A.-B. Lindgren, S. Lindh, G. Giacomet, V. Merlo, M. Figini, C. Erba, P. Viganò, A. Hannam, S. Mieli-Vergani, G. Hatzakis, A. Inchley, C. Fjaerli, H.O. Maccabruni, A. Marcellini, M. Sartorelli, M.R. Fontelos, P.M. Mazza, A. Mok, J.Y.Q. Mûr, A. Viñolas, M. Paternoster, D.M. Grella, P. Polywka, S. Quinti, I. Casadei, A.M. Rojahn, A. Berg, A. Rosso, R. Ferrando, S. Bassetti, D. Contreras, J.R. Manzanares, A. Extremera, A.R. Salvini, F. Zuccotti, G.V. Schmitz, T. Grosch-Wörner, I. Sperling, C.F. Piening, T. Vegnente, A. Iorio, R. Versace, A. Lazier, L. Palomba, E. Gabiano, C. Balbo, L. Zanetti, A. Tanzi, E.

Subjects
virus diseases, digestive system diseases
Abstract

Background/Aims: As evidence accumulates relating to mother-to-child (vertical) transmission of hepatitis C virus (HCV), it is timely to draw up guidelines for the clinical management of HCV infected pregnant women and their children. Methods: A review of evidence from the European Paediatric HCV Network (EPHN) prospective study of HCV infected women and their children and other published studies. Meeting of EPHN clinical experts to reach a consensus on recommendations for management. Each recommendation was graded according to the level of evidence. Results/conclusions: Although several risk factors for mother-to-child transmission have been identified, none are modifiable and there are currently no interventions available to prevent vertical transmission of HCV. Data on timing of loss of maternal antibodies and reliability of diagnostic tests inform the optimum follow-up schedule for confirmation or exclusion of infection in children born to HCV infected women. Based on the current evidence, routine antenatal screening for HCV should not be introduced and neither elective caesarean section nor avoidance of breastfeeding should be recommended to HCV infected women to prevent mother-to-child transmission of HCV. HCV/HIV co-infected women should follow existing HIV guidelines. © 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Published
2005

40. Lower mother to child HIV-1 transmission in boys is independent of type of delivery and antiretroviralprophylaxis

Author

Galli, The Italian Register for HIV infection in c. h. i. l. d. r. e. n. Writing committee: L., Puliti, D., Chiappini, E., Gabiano, C., Tovo, P. A., Pezzetti, P., Osimani, M. de M. a. r. t. i. n. o. Partecipants: P., De Mattia, D., Di Bari, C., Manzionna, M., Cornelli, A., Ruggeri, M., Baldi, F., Bosi, I., Ciccia, M., Faldella, A., Lanari, M., Martelli, M., Masi, M., Duse, M., Fausti, R., Schumacher, R., Chiriaco, G., Dedoni, M., Dessi, C., Gariel, D., Anastasio, E., Grassi, A., Sticca, M., Vivalda, A., Bezzi, T., Fiumana, E., Placido, A., Viticci, P., Bigi, S. C. o. l. l. i. n. i. A., Cecchi, M. T., Di Siena, G., Lobello, D., Cosso, D., Timitilli, A., Mussini, P., Ferraris, G., De Giacomo, C., Giacomet, V., Giovannini, M., Lipreri, R., Pinzani, R., Plebani, A., Salvini, F., Schneider, L., Viganò, A., Zuccotti, G. V., Cano, C., Cellini, M., Buffolano, W., Guarino, A., Tarallo, L., D’Elia, R., Giaquinto, C., Rampon, O., ER Dalle Nogare, Romano, A., Saitta, M., Bergamasco, M., Maccabruni, A., and Consolini, Rita

Published
2005

42. Inter-laboratory comparison of HCV-RNA assay results: Implications for multi-centre research

Author

Pembrey, L. Newell, M.-L. Tovo, P.-A. Van Drimmelen, H. Quinti, I. Furlini, G. Galli, S. Meliconi, M.G. Burns, S. Hallam, N. Sönnerborg, A. Cilia, G. Serrano, E. Laccetti, P. Portella, G. Polywka, S. Icardi, G. Bruzzone, B. Balbo, L. Alfarano, A. Amoroso, A. Asensi-Botet, F. Bona, G. Boucher, C. Buffolano, W. Butler, K. Cabero Roura, L. Bertran Sanges, J.M. Cigna, P. Ciria, L.M. Servera Ginard, C. Coll, O. Fortuny, C. Corrias, A. Ledda, R. Floris, S. De Maria, A. Echeverria, J. Cilla, G. Fabris, C. Feiterna Sperling, C. Grosch-Wörner, I. Fischler, B. Bohlin, A.-B. Fjaerli, H.A. Hannam, S. Mieli-Vergani, G. Hatzakis, A. Lanari, M. Papa, I. Venturi, V. Leon Leal, J.A. Lyall, H. Maccabruni, A. Pacati, I. Arlandi, L. Marcellini, M. Martin Fontelos, P. Mazza, A. Mok, J.Y.Q. Mûr, A. Viñolas, M. Palomba, E. Riva, C. Scolfaro, C. Paternoster, D.M. Grella, P. Casadei, A.M. Rojahn, A. Rosso, R. Bassetti, D. Ruiz Contreras, J. Manzanares, A. Ruiz Extremera, A. Souayah, H. Levy, J. Tudor-Williams, G. Vegnente, A. Wejstal, R. Norkrans, G. Zanetti, A. Tanzi, E. Zuccotti, G.V. Zuin, G. Saccani, B. Vigano, A.

Abstract

To investigate whether it is appropriate to assume comparability of hepatitis virus C (HCV)-RNA results across laboratories in multi-centre studies, nine laboratories of the European Paediatric HCV Network participated in an international proficiency study of HCV-RNA assays. A panel of 12 samples of different dilutions and genotypes was sent to each laboratory and tested with qualitative and/or quantitative HCV-RNA assays according to local procedures. Commercial assays were used in seven laboratories and in-house assays in two. All six laboratories in which a commercial qualitative assay was used were proficient, as were four of six runs (in five laboratories) in which a commercial quantitative assay was used. The proficiency of the laboratories where in-house assays were used could not be assessed according to the VQC definition because of differences in the methods used. Overall, there were several false-negative results, but only one false-positive result with a quantitative assay and none with a qualitative assay. The false-negative results may have implications for the diagnosis of infection, and highlight the need for an antibody test to be performed at 18 months to confirm the absence of infection. The results of qualitative assays were generally consistent across laboratories but it was difficult to evaluate and compare the results of quantitative assays. Multivariate analysis of data collected in multi-centre studies should therefore allow for centre and/or assay used. © 2003 Wiley-Liss, Inc.

Published
2003

46. The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection

Author

Carmelina, Calitri, Clara, Gabiano, Luisa, Galli, Elena, Chiappini, Carlo, Giaquinto, Wilma, Buffolano, Orazio, Genovese, Susanna, Esposito, Stefania, Bernardi, Maurizio De Martino, Pier Angelo Tovo, Osimani, P, Larovere, D, Ruggeri, M, Pession, A, Faldella, G, Capra, F, Pulcini, S, Zattoni, V, Dedoni, M, Aliffi, A, Anastasio, E, Fiumana, E, Gervaso, P, Montagnani, C, Di Biagio, A, Nicolini, La, De Hoffer, L, Acutis, Ms, Bondi, E, Erba, P, Fabiano, V, Ramponi, G, Salvini, F, Lipreri, R, Esposito, S, Plebani, A, Tagliabue, C, Giubbarelli, F, Nicastro, E, Lo Vecchio, A, Buffolano, W, Agnese, M, Romano, A, Giaquinto, C, Rampon, O, Pennazzato, M, Consolini, Rita, Dodi, I, Maccabruni, A, Genovese, O, Palma, P, Pontrelli, G, Tchidjou, H, Olmeo, P, Mazza, A, Silvestro, E, Virano, S, Portelli, V, Rabusin, M, and Pellegatta, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Pediatric hiv, Anti-HIV Agents, Birth weight, HIV Infections, Young Adult, Medical microbiology, Pregnancy, Antiretroviral Therapy, Highly Active, medicine, Birth Weight, Humans, Prospective Studies, Young adult, Pregnancy Complications, Infectious, Prospective cohort study, AZT, Drug-resistant virus, HIV-1, Vertical transmission, Cesarean Section, Child, Female, Infant, Italy, Pregnancy Outcome, Viral Load, Zidovudine, Infectious Disease Transmission, Vertical, Infectious Diseases, business.industry, virus diseases, medicine.disease, Antiretroviral therapy, Settore MED/38, business, Viral load, Research Article
Abstract

Background In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing. Methods A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children. Results Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2–6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275–522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36–38, median birth weight: 2550 grams, IQR 2270 – 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 – 42), with no adverse events reported. No child acquired HIV-1 infection. Conclusions Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

Published
2014

47. Effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus: European Paediatric Hepatitis C Virus Network

Author

Tovo, P.-A. Newell, M.-L. Coll, O. de Tejada, B.M. Lanari, M. Bosi, I. Papa, I. Zanetti, A. Contreras, J.R. Manzanares, A. Ramos, J.T. Vegnente, A. Iorio, R. Fabris, C. Bandelloni, A.M. Tibaldi, C. Ciria, L.M. Palomba, E. Riva, C. Scolfaro, C. Buffolano, W. Scotese, I. Micco, A. Marcellini, M. Sartorelli, M.R. Mattia, S. Bohlin, A.-B. Fischler, B. Lindgren, S. Lindh, G. Maccabruni, A. Pacati, I. Arlandi, L. Polywka, S. Butler, K. De Maria, A. Bassetti, D. Fioredda, F. Boni, S. Gotta, C. Mazza, A. Grosch-Wörner, I. Sperling, C.F. Quinti, I. Scaravelli, G. Cigna, P. Cilla, G. Echeverria, J. Souayah, H. Grossman, D. Levy, J. Bona, G. Mok, J.Y.Q. Fontelos, P.M. Arrieta, J.V. Asensi-Botet, F. Otero, M.C. Pérez-Tamarit, D. Zuin, G. Saccani, B. Zuccotti, G.V. Riva, E. Gamboni, A. Wejstal, R. Norkrans, G. Scherpbier, H. Mûr, A. Viñolas, M. Extremera, A.R. Roura, L.C. McBertran Sanges, J. McLeon Leal, J.A. Rodriguez, A. Sarrión-Auñón, A. Corrias, A. Boucher, C. Hatzakis, A. Grella, P.

Abstract

Objective: To investigate the effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus. Design: Pooled retrospective analysis of prospectively collected data. Sample: Data on hepatitis C virus seropositive mothers and their children identified around delivery were sent from 24 centres of the European Paediatric Hepatitis C Virus Network. Main outcome measures: Hepatitis C virus infection status of children born to hepatitis C virus infected women. Results: A total of 1,474 hepatitis C virus infected women were identified, of whom 503 (35%) were co-infected with HIV. Co-infected women were more than twice as likely to transmit hepatitis C virus to their children than women with hepatitis C virus infection alone. Overall 9.2% (136/1474) of children were hepatitis C virus infected. Among the women with hepatitis C virus infection-only, multivariate analyses did not show a significant effect of mode of delivery and breastfeeding: caesarean section vs vaginal delivery OR = 1.17, P: 0.66; breastfed versus non-breastfed OR = 1.07, P = 0.83. However, HIV co-infected women delivered by caesarean section were 60% less likely to have an infected child than those delivered vaginally (OR = 0.36, P = 0.01) and those who breastfed were about four times more likely to infect their children than those who did not (OR = 6.41, P: 0.03). HIV infected children were three to four times more likely also to be hepatitis C virus infected than children without HIV infection (crude OR = 3.76, 95% CI 1.89-7.41). Conclusions: These results do not support a recommendation of elective caesarean section or avoidance of breastfeeding for women with hepatitis C virus infection only, but the case for HIV infected women undergoing caesarean section delivery and avoiding breastfeeding is strengthened if they are also hepatitis C virus infected.

Published
2001

48. Sources of toxoplasma infection in pregnant women. European multicentre case control study

Author

Cook, Aj., Gilbert, R.e., Buffolano, W., Zufferey, J., Petersen, E., Jenum, Pa., Foulon, Walter, Semprini, Ae., Dunn, Dt., Surgery Specializations, and Vrije Universiteit Brussel

Abstract

Objective: To determine the odds ratio and population attributable fraction associated with food and environmental risk factors for acute toxoplasmosis in pregnancy. Design: Case-control study. Setting: Six large European cities. Participants: Pregnant women with acute infection (cases) detected by seroconversion or positive for anti-Toxoplasma gondii IgM were compared with pregnant women seronegative for toxoplasma (controls). Main outcome measures: Odds ratios for acute infection adjusted for confounding variables; the population attributable fraction for risk factors. Results: Risk factors most strongly predictive of acute infection in pregnant women were eating undercooked lamb, beef, or game, contact with soil, and travel outside Europe and the United States and Canada. Contact with cats was not a risk factor. Between 30% and 63% of infections in different centres were attributed to consumption of undercooked or cured meat products and 6% to 17% to soil contact. Conclusions: Inadequately cooked or cured meat is the main risk factor for infection with toxoplasma in all centres. Preventive strategies should aim to reduce prevalence of infection in meat, improve labelling of meat according to farming and processing methods, and improve the quality and consistency of health information given to pregnant women.

Published
2000

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