Management and Outcome of Pregnant Women with HIV Acquired by Vertical Transmission

The majority of children with perinatally acquired human immunodeficiency virus (HIV) do not survive beyond childhood but this is changing due to the benefit of antiretroviral therapy for the perinatally infected cohort, so affected children are now approaching the age to be mothers. The aim of this article is to evaluate the outcomes of pregnant women with HIV acquired by vertical transmission in our centre and encourage the results obtained in “Thirty Years Later: Pregnancies in Female Perinatally Infected with Human Immunodeficiency Virus-1”, a review article published in this journal in 2012 [2]. We report 6 patients with eight pregnancies with HIV acquired by vertical transmission. They delivered a total of nine newborns between 2004 and 2013. In any case, mother-to-child transmission was reported. The management of pregnant women with HIV acquired by vertical transmission is complicated, since the patients are the most of the cases young and the compliance to the treatment may be poor. The prematurity was the more frequent complication and the cesarean section was the more frequent form of ending. In our case series, mother-to-child transmission was absent.

Impact of HIV on the health-related quality of life in youth with perinatally acquired HIV

Background Studies investigating health-related quality of life(HRQoL)in youth with perinatally acquired HIV(PHIV+)are scarce.This study aimed to compare HRQoL of PHIV+to sociodemographic-matched youth not living with HIV(HIV-),Spanish general youth population,and to explore associations between sociodemographic variables,drug consumption,and HRQoL.Methods PHIV+youth were randomly selected from CoRISpe database(Cohort of the Spanish Pediatric HIV Network).HRQoL was evaluated by SF-12v2.Results Thirty-nine PHIV+youth(mean age:23.36 years,SD=3.83)and thirty-nine HIV-youth(mean age:22.97 years,SD=3.80)participated in this study.PHIV+obtained lower scores in SF-12 physical health subscale(PCS)than HIV-(P=0.001)and Spanish general youth population(P=0.006).PHIV+had lower scores on the mental health subscale(MCS)than the Spanish general youth population(P<0.001).PHIV+who were at school obtained better scores than those were not at school.PHIV+youth who had used cocaine and cannabis had lower scores in MCS(P=0.002).Conclusions There is a need for HRQoL management in the associated medical follow-up.

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Objective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy(HAART).However,little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh.This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital,Bangladesh from January 2017 and December 2020.Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study.Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS,22(55.0%)were male and 18(45.0%)were female.The patients ranged in age from 8 to 60 years,with a mean age of 38±0.966 years.Among all age groups,the highest 19(47.5%)patients were in the 31-to 40-year age group.Most of the patients were migrant workers[22/40(55.0%)]with low socioeconomic status[32/40(80.0%)],and the most common transmission mode was heterosexual activity[36/40(90.0%)].Most of the patients[32/40(80.0%)]had mucocutaneous disorders,30/40(75.0%)had infective dermatoses,and 21/40(52.5%)had non-infective inflammatory dermatoses.Eight of forty(20.0%)patients presented with three or more skin disorders.The most common infective dermatoses were fungal infections[15/40(37.5%)],followed by viral infections[8/40(20.0%)],bacterial infections[4/40(10.0%)],and scabies[3/40(7.5%)].The most common non-infective dermatosis was generalized pruritus[6/40(15.0%)],followed by prurigo simplex[4/40(10.0%)],psoriasis[4/40(10.0%)],eczema[3/40(7.5%)],pruritic papular eruption[1/40(2.5%)],seborrheic dermatitis[1/40(2.5%)],urticaria[1/40(2.5%)],and xerosis[1/40(2.5%)].Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions[19/40(47.5%)].The most common drug eruption following HAART was a morbilliform rash[11/40(27.5%)],and the most common offending agent was nevirapine.The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of<200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS,and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders.Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh.There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients withHIV/AIDS.