Ramona Georgiana Varsa, N. Gică, Mihaela Demetrian, A. Ciobanu, R. Botezatu, C. Gică, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu
Toxoplasmosis is a worldwide spread infection, caused by the parasite Toxoplasma gondii, acquired through ingestion of contaminated food or water, or consuming infected undercooked meat. Despite the fact that in healthy, non-pregnant population, this infection is predominantly asymptomatic and self-limited, in pregnancy it requires special care to minimize the risks to the fetus by vertical transmission. Congenital toxoplasmosis can result in permanent neurological impairment and even blindness. Once diagnosed in pregnancy, this infection needs prompt medical therapy to prevent fetal complications. Primary prevention of the toxoplasmosis consists of dietary and lifestyle changes with the purpose to limit the contact with the parasite. Secondary prevention includes the screening of the pregnant women. Screening programs are implemented in various countries depending on the prevalence of the parasite in the respective areas. The purpose of this article is to make a review of the medical literature concerning the management of Toxoplasma gondii infection in pregnancy. For this purpose, scientific research in databases and online medical publications such as Medline, PubMed, Elsevier and The Lancet was conducted.
{"title":"Toxoplasma gondii infection in pregnancy","authors":"Ramona Georgiana Varsa, N. Gică, Mihaela Demetrian, A. Ciobanu, R. Botezatu, C. Gică, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.5","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.5","url":null,"abstract":"Toxoplasmosis is a worldwide spread infection, caused by the parasite Toxoplasma gondii, acquired through ingestion of contaminated food or water, or consuming infected undercooked meat. Despite the fact that in healthy, non-pregnant population, this infection is predominantly asymptomatic and self-limited, in pregnancy it requires special care to minimize the risks to the fetus by vertical transmission. Congenital toxoplasmosis can result in permanent neurological impairment and even blindness. Once diagnosed in pregnancy, this infection needs prompt medical therapy to prevent fetal complications. Primary prevention of the toxoplasmosis consists of dietary and lifestyle changes with the purpose to limit the contact with the parasite. Secondary prevention includes the screening of the pregnant women. Screening programs are implemented in various countries depending on the prevalence of the parasite in the respective areas. The purpose of this article is to make a review of the medical literature concerning the management of Toxoplasma gondii infection in pregnancy. For this purpose, scientific research in databases and online medical publications such as Medline, PubMed, Elsevier and The Lancet was conducted.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42637512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Panaitescu, Dalila Toma, N. Gică, B. Cimpoca-Raptis, A. Ciobanu, M. Popescu, R. Botezatu, G. Peltecu
The COVID-19 pandemic has changed the lives of millions of people across the globe. As of November 2021, WHO has reported more than 250 million confirmed cases of SARS-CoV-2 infection with more than 5 million deaths. Despite the continuous efforts being made by the medical community to address the fundamental questions posed by the SARSCoV-2 infection in pregnant women and its impact over the mother and the offspring. The aim of this paper is to assess the evidence accumulated since the emergence of the pandemic concerning the impact of SARS-CoV-2 infection on the mother and fetus, especially addressing the risks of intrauterine death in SARS-CoV-2 positive mothers. We searched different databases up to November 2021 for variations of the sentence: "SARS-CoV-2 infection and COVID-19 and pregnancy and fetal death, stillbirth, intrauterine death". The changing physiological and immune responses during pregnancy make a pregnant woman more prone to developing severe forms of COVID-19, causing sometimes serious pregnancy complications such as fetal loss. At times mild general symptoms related to COVID-19 can cause serious fetal complications, suggesting that placental changes are responsible for fetal outcome. Infection with non-Delta variant increases the risk of fetal loss in the third trimester two times compared to healthy population, while Delta variant increases this risk four times. The exact mechanism of vertical transmission is still to be established and these aspects need further research especially assessing COVID-19 variant particularities.
{"title":"SARS-CoV-2 infection in pregnancy and risk of stillbirth","authors":"A. Panaitescu, Dalila Toma, N. Gică, B. Cimpoca-Raptis, A. Ciobanu, M. Popescu, R. Botezatu, G. Peltecu","doi":"10.37897/rjid.2021.s.16","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.16","url":null,"abstract":"The COVID-19 pandemic has changed the lives of millions of people across the globe. As of November 2021, WHO has reported more than 250 million confirmed cases of SARS-CoV-2 infection with more than 5 million deaths. Despite the continuous efforts being made by the medical community to address the fundamental questions posed by the SARSCoV-2 infection in pregnant women and its impact over the mother and the offspring. The aim of this paper is to assess the evidence accumulated since the emergence of the pandemic concerning the impact of SARS-CoV-2 infection on the mother and fetus, especially addressing the risks of intrauterine death in SARS-CoV-2 positive mothers. We searched different databases up to November 2021 for variations of the sentence: \"SARS-CoV-2 infection and COVID-19 and pregnancy and fetal death, stillbirth, intrauterine death\". The changing physiological and immune responses during pregnancy make a pregnant woman more prone to developing severe forms of COVID-19, causing sometimes serious pregnancy complications such as fetal loss. At times mild general symptoms related to COVID-19 can cause serious fetal complications, suggesting that placental changes are responsible for fetal outcome. Infection with non-Delta variant increases the risk of fetal loss in the third trimester two times compared to healthy population, while Delta variant increases this risk four times. The exact mechanism of vertical transmission is still to be established and these aspects need further research especially assessing COVID-19 variant particularities.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41348558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Scutelnicu, R. Botezatu, C. Gică, G. Peltecu, N. Gică, Mihaela Demetrian, A. Panaitescu
Rubella is the most important preventable cause of fetal malformations. Infection during pregnancy can result in fetal growth restriction, miscarriage, fetal death or it can cause congenital rubella syndrome with visual, auditory and cardiac defects. There are still many developping countries which are endemic for Rubella, despite major vaccination programmes available worldwide. There are no clinical symptoms present in approximately one half of cases, so diagnosis relies on serological testing if infection is suspected. Detection of IgM specific antibodies is the method of choice for diagnosis of both postnatal and congenital rubella. It has high sensitivity, but false positive cases are always possible after infection with other viruses like parvovirus B19, Epstein-Barr virus, cytomegalovirus and measles. Prevention relies on preconception care when it is recommended to check the immunity status for rubella (IgG) and for non-immunized patients, vaccination should be indicated.
{"title":"Rubella in pregnancy. Still a concern","authors":"A. Scutelnicu, R. Botezatu, C. Gică, G. Peltecu, N. Gică, Mihaela Demetrian, A. Panaitescu","doi":"10.37897/rjid.2021.s.12","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.12","url":null,"abstract":"Rubella is the most important preventable cause of fetal malformations. Infection during pregnancy can result in fetal growth restriction, miscarriage, fetal death or it can cause congenital rubella syndrome with visual, auditory and cardiac defects. There are still many developping countries which are endemic for Rubella, despite major vaccination programmes available worldwide. There are no clinical symptoms present in approximately one half of cases, so diagnosis relies on serological testing if infection is suspected. Detection of IgM specific antibodies is the method of choice for diagnosis of both postnatal and congenital rubella. It has high sensitivity, but false positive cases are always possible after infection with other viruses like parvovirus B19, Epstein-Barr virus, cytomegalovirus and measles. Prevention relies on preconception care when it is recommended to check the immunity status for rubella (IgG) and for non-immunized patients, vaccination should be indicated.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48978391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Cioroba, C. Gică, R. Botezatu, Mihaela Demetrian, N. Gică, G. Peltecu, A. Ciobanu, B. Cimpoca-Raptis, A. Panaitescu
Frequently, enteroviral infection with Coxsackie virus B (CV-B) goes unnoticed, without or only with mild symptoms. The infection is well known for the gastro-intestinal transmission, but recently, the severe forms of neonate’s infection, suggested that vertical transmission should not be neglected and moreover the fetal consequences should be studied. This review relates the most important findings regarding infection with CV-B during pregnancy, most of the information being based on murine studies. It seems that CV-B infection is associated with high rate of abortion and could also impair fertility. Regarding long term effects, CV-B might cause autoimmune diseases, congenital heart defects and neurologic disorders. Severe acute disease in new-born is generally acquired from a symptomatic mother that develop a febrile illness during the last week of pregnancy.
{"title":"Coxsackie virus B infection and pregnancy","authors":"T. Cioroba, C. Gică, R. Botezatu, Mihaela Demetrian, N. Gică, G. Peltecu, A. Ciobanu, B. Cimpoca-Raptis, A. Panaitescu","doi":"10.37897/rjid.2021.s.14","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.14","url":null,"abstract":"Frequently, enteroviral infection with Coxsackie virus B (CV-B) goes unnoticed, without or only with mild symptoms. The infection is well known for the gastro-intestinal transmission, but recently, the severe forms of neonate’s infection, suggested that vertical transmission should not be neglected and moreover the fetal consequences should be studied. This review relates the most important findings regarding infection with CV-B during pregnancy, most of the information being based on murine studies. It seems that CV-B infection is associated with high rate of abortion and could also impair fertility. Regarding long term effects, CV-B might cause autoimmune diseases, congenital heart defects and neurologic disorders. Severe acute disease in new-born is generally acquired from a symptomatic mother that develop a febrile illness during the last week of pregnancy.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48918640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Dumitru, N. Gică, R. Botezatu, C. Gică, Mihaela Demetrian, A. Ciobanu, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu
Listeria monocytogenes is an important pathogenic bacteria found in soil or water being the causative agent of listeriosis, a severe foodborne disease during pregnancy. The outcome can lead up to miscarriage, stillbirth, preterm birth and congenital neonatal infections, under occult or overt illness of the mother. We performed a literature review in the medical database PubMed, searching relevant information regarding listeriosis during pregnancy and neonatal outcome. Higher incidences were observed in ethnic minorities, as a reflection of specific dietary habits and where surveillance is not thoroughly implemented. Also, the infection was most commonly seen during the second or third trimester of pregnancy, with maternal presentation under the form of flu-like or pyelonephritis symptoms, or even asymptomatic. Regarding the neonatal infection, there are two types described according to the way of acquiring the bacteria. The obstetric outcome ranges from premature delivery to miscarriage and stillbirth. Treatment of choice is a combination of ampicillin and aminoglycoside. Despite the advances in the field of infectious diseases, challenges remain to completely understand the mechanism of placental invasion of Listeria monocytogenes and the severe consequences on fetal development.
{"title":"Listeria monocytogenes infection during pregnancy","authors":"A. Dumitru, N. Gică, R. Botezatu, C. Gică, Mihaela Demetrian, A. Ciobanu, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.10","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.10","url":null,"abstract":"Listeria monocytogenes is an important pathogenic bacteria found in soil or water being the causative agent of listeriosis, a severe foodborne disease during pregnancy. The outcome can lead up to miscarriage, stillbirth, preterm birth and congenital neonatal infections, under occult or overt illness of the mother. We performed a literature review in the medical database PubMed, searching relevant information regarding listeriosis during pregnancy and neonatal outcome. Higher incidences were observed in ethnic minorities, as a reflection of specific dietary habits and where surveillance is not thoroughly implemented. Also, the infection was most commonly seen during the second or third trimester of pregnancy, with maternal presentation under the form of flu-like or pyelonephritis symptoms, or even asymptomatic. Regarding the neonatal infection, there are two types described according to the way of acquiring the bacteria. The obstetric outcome ranges from premature delivery to miscarriage and stillbirth. Treatment of choice is a combination of ampicillin and aminoglycoside. Despite the advances in the field of infectious diseases, challenges remain to completely understand the mechanism of placental invasion of Listeria monocytogenes and the severe consequences on fetal development.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46295563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Duminica-Turcu, R. Botezatu, C. Gică, G. Peltecu, N. Gică, Mihaela Demetrian, A. Panaitescu
Issues regarding parvovirus B19 infection in pregnancy continue to arouse the interest of obstetricians all over the world, the main concern focusing on maternal outcomes and fetal consequences of the intrapartum infection. Parvovirus B19 infection remains one of the main etiologies of fetal anemia and non-immune hydrops, implying a high risk of neonatal demise. This high rate of maternal and neonatal morbidity entails a special attention towards the clinical manifestations and treatment of parvovirus B19 infection during pregnancy time. A systematic literature review was obtained from over 100 articles related to the chosen subject, out of which 27 articles were chosen as relevant to the above-mentioned subject.
{"title":"Parvovirus infection and pregnancy","authors":"Ana Duminica-Turcu, R. Botezatu, C. Gică, G. Peltecu, N. Gică, Mihaela Demetrian, A. Panaitescu","doi":"10.37897/rjid.2021.s.8","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.8","url":null,"abstract":"Issues regarding parvovirus B19 infection in pregnancy continue to arouse the interest of obstetricians all over the world, the main concern focusing on maternal outcomes and fetal consequences of the intrapartum infection. Parvovirus B19 infection remains one of the main etiologies of fetal anemia and non-immune hydrops, implying a high risk of neonatal demise. This high rate of maternal and neonatal morbidity entails a special attention towards the clinical manifestations and treatment of parvovirus B19 infection during pregnancy time. A systematic literature review was obtained from over 100 articles related to the chosen subject, out of which 27 articles were chosen as relevant to the above-mentioned subject.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70136952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ilinca Ilie, N. Gică, R. Botezatu, Mihaela Demetrian, A. Ciobanu, B. Cimpoca-Raptis, C. Gică, G. Peltecu, A. Panaitescu
Group B streptococcal (GBS) disease and its early onset continues to pose major economic and perinatal implications regarding maternal and neonatal morbidity and mortality rates and methods of treatment. Universal GBS screening via rectovaginal culture is now recommended between 36 and 37 weeks and 6 days of gestation for all pregnant women. Timely identification of groups of women suitable for intravenous intrapartum antibiotic prophylaxis of GBS early onset infection has also proven to be effective, although less so than the universal screening approach.
{"title":"Prevention of neonatal group B streptococcal disease","authors":"Ilinca Ilie, N. Gică, R. Botezatu, Mihaela Demetrian, A. Ciobanu, B. Cimpoca-Raptis, C. Gică, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.7","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.7","url":null,"abstract":"Group B streptococcal (GBS) disease and its early onset continues to pose major economic and perinatal implications regarding maternal and neonatal morbidity and mortality rates and methods of treatment. Universal GBS screening via rectovaginal culture is now recommended between 36 and 37 weeks and 6 days of gestation for all pregnant women. Timely identification of groups of women suitable for intravenous intrapartum antibiotic prophylaxis of GBS early onset infection has also proven to be effective, although less so than the universal screening approach.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43863886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Cudalbă, N. Gică, R. Botezatu, G. Peltecu, C. Gică, Mihaela Demetrian, A. Panaitescu
Preterm delivery represents the leading cause of perinatal morbidity and mortality. Among possible etiologies of premature birth are the infectious ones, Human Papilloma Virus (HPV) infection being less documented than others. The available data on the role of HPV infection in premature delivery pathogenesis is limited and controversial. This review article attempts to make an assessment of current information on the risk of premature delivery in women with HPV infection during pregnancy. A systematic literature electronic search for journal articles and guidelines regarding HPV infection during pregnancy was undertaken. The relationship between HPV infection and pregnancy is bidirectional, as physiological changes that occur during pregnancy modulate the mechanisms of HPV infection and HPV infection determine adverse maternal, obstetrical, and fetal outcomes.
{"title":"HPV and premature delivery risk","authors":"D. Cudalbă, N. Gică, R. Botezatu, G. Peltecu, C. Gică, Mihaela Demetrian, A. Panaitescu","doi":"10.37897/rjid.2021.s.9","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.9","url":null,"abstract":"Preterm delivery represents the leading cause of perinatal morbidity and mortality. Among possible etiologies of premature birth are the infectious ones, Human Papilloma Virus (HPV) infection being less documented than others. The available data on the role of HPV infection in premature delivery pathogenesis is limited and controversial. This review article attempts to make an assessment of current information on the risk of premature delivery in women with HPV infection during pregnancy. A systematic literature electronic search for journal articles and guidelines regarding HPV infection during pregnancy was undertaken. The relationship between HPV infection and pregnancy is bidirectional, as physiological changes that occur during pregnancy modulate the mechanisms of HPV infection and HPV infection determine adverse maternal, obstetrical, and fetal outcomes.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45546150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Mugescu, Mihaela Demetrian, N. Gică, R. Botezatu, C. Gică, G. Peltecu, A. Ciobanu, B. Cimpoca-Raptis, A. Panaitescu
Hepatitis C virus (HCV) infection has a rather noticeable effect on pregnancy, considering the fact that two entities are involved: the mother and the fetus. It has become a worldwide health threat, so forward actions are to be taken in order to minimize the impact on morbidity and mortality caused by this virus. We conducted this review article based on data from 33 articles published between 2016 and 2021 that assessed both maternal and fetal outcomes, long term effect on children born to HCV infected mothers, screening for HCV among pregnant women, vertical transmission, recommendations for the management of HCV infected pregnant patient, available medication and the need for treating HCV during pregnancy. The majority of authors concluded that HCV has a greater impact on the fetus/child rather than on mother and also, most of them are calling in for the need to treat this infection during pregnancy in order to diminish the risk of vertical transmission, therefore to reduce the incidence of HCV infection among infants. The necessity for further studies, especially on safety data for antiviral medication is imperative, as well as the need for new steps in downsizing the impact of HCV infection on individuals around the globe.
{"title":"Hepatitis C virus infection and pregnancy – not the simplest combination","authors":"C. Mugescu, Mihaela Demetrian, N. Gică, R. Botezatu, C. Gică, G. Peltecu, A. Ciobanu, B. Cimpoca-Raptis, A. Panaitescu","doi":"10.37897/rjid.2021.s.3","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.3","url":null,"abstract":"Hepatitis C virus (HCV) infection has a rather noticeable effect on pregnancy, considering the fact that two entities are involved: the mother and the fetus. It has become a worldwide health threat, so forward actions are to be taken in order to minimize the impact on morbidity and mortality caused by this virus. We conducted this review article based on data from 33 articles published between 2016 and 2021 that assessed both maternal and fetal outcomes, long term effect on children born to HCV infected mothers, screening for HCV among pregnant women, vertical transmission, recommendations for the management of HCV infected pregnant patient, available medication and the need for treating HCV during pregnancy. The majority of authors concluded that HCV has a greater impact on the fetus/child rather than on mother and also, most of them are calling in for the need to treat this infection during pregnancy in order to diminish the risk of vertical transmission, therefore to reduce the incidence of HCV infection among infants. The necessity for further studies, especially on safety data for antiviral medication is imperative, as well as the need for new steps in downsizing the impact of HCV infection on individuals around the globe.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49627809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carina Ragea, N. Gică, R. Botezatu, Mihaela Demetrian, C. Gică, A. Ciobanu, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu
This review aims to evaluate the prevention strategies of perinatal HIV infections and their efficacy worldwide, both in resource-limited and in resource-rich regions. Furthermore, it presents the most recent aspects of obstetric management of HIV-infected mothers. The introduction of combined antiretroviral therapy (ART) has decreased mother-to-child HIV transmission in high-income settings to historically low levels. Efforts to implement antiretroviral agents in resource-limited countries were also successful in reducing perinatal transmission. However, there are differences in prevention strategies between low and high-resource settings regarding the mode of delivery and infant feeding advice. The three-part prevention strategy (antepartum, intrapartum, and infant prophylaxis) is the most effective approach. Viral load suppression by antiretroviral treatment up to the time of birth is the most effective way to reduce perinatal transmission. Viral load and not HIV status should be used to determine the mode of delivery. Furthermore, the duration of prolonged rupture of membranes is not associated with an increased risk of HIV transmission in women with low viral load. Breastfeeding is contraindicated for mothers living with HIV in resource-rich settings, whereas in low-income areas breastfeeding remains the main nutritional source for infants. ART should be initiated as early as possible in newly diagnosed pregnant women and should be continued for life. Preventive strategies of perinatal HIV transmission have become extraordinarily successful, especially due to the introduction of antiretroviral therapy. Key strategies in the prevention of mother- to-child transmission are prompt identification and treatment of HIV-infected mothers and postpartum infant prophylaxis.
{"title":"Prevention of mother-to-child transmission of HIV infection","authors":"Carina Ragea, N. Gică, R. Botezatu, Mihaela Demetrian, C. Gică, A. Ciobanu, B. Cimpoca-Raptis, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.13","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.13","url":null,"abstract":"This review aims to evaluate the prevention strategies of perinatal HIV infections and their efficacy worldwide, both in resource-limited and in resource-rich regions. Furthermore, it presents the most recent aspects of obstetric management of HIV-infected mothers. The introduction of combined antiretroviral therapy (ART) has decreased mother-to-child HIV transmission in high-income settings to historically low levels. Efforts to implement antiretroviral agents in resource-limited countries were also successful in reducing perinatal transmission. However, there are differences in prevention strategies between low and high-resource settings regarding the mode of delivery and infant feeding advice. The three-part prevention strategy (antepartum, intrapartum, and infant prophylaxis) is the most effective approach. Viral load suppression by antiretroviral treatment up to the time of birth is the most effective way to reduce perinatal transmission. Viral load and not HIV status should be used to determine the mode of delivery. Furthermore, the duration of prolonged rupture of membranes is not associated with an increased risk of HIV transmission in women with low viral load. Breastfeeding is contraindicated for mothers living with HIV in resource-rich settings, whereas in low-income areas breastfeeding remains the main nutritional source for infants. ART should be initiated as early as possible in newly diagnosed pregnant women and should be continued for life. Preventive strategies of perinatal HIV transmission have become extraordinarily successful, especially due to the introduction of antiretroviral therapy. Key strategies in the prevention of mother- to-child transmission are prompt identification and treatment of HIV-infected mothers and postpartum infant prophylaxis.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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