For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
100
views
42
references
 Top references
cited by
99
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      69
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis.

      Read this article at

      ScienceOpenPublisherPMC
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT) risk among women with incident versus chronic infection.

          Related collections

          Most cited references42

          • Record: found
          • Abstract: found
          • Article: not found

          Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2.

          S Delany, W Whittington, Robert J Hughes … (2010)
          Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P<0.001) and the occurrence of HSV-2-positive genital ulcers by 73% (risk ratio, 0.27; 95% CI, 0.20 to 0.36; P<0.001). A total of 92% of the partners infected with HIV-1 and 84% of the partners not infected with HIV-1 remained in the study for 24 months. The level of adherence to the dispensed study drug was 96%. No serious adverse events related to acyclovir were observed. Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction in plasma HIV-1 RNA of 0.25 log(10) copies per milliliter and a 73% reduction in the occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519.) 2010 Massachusetts Medical Society
          Article 0 comments Cited 163 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effect of aciclovir on HIV-1 acquisition in herpes simplex virus 2 seropositive women and men who have sex with men: a randomised, double-blind, placebo-controlled trial.

            , Beryl Koblin, Jing-Wen Wang … (2008)
            Across many observational studies, herpes simplex virus type 2 (HSV-2) infection is associated with two-fold to three-fold increased risk for HIV-1 infection. We investigated whether HSV-2 suppression with aciclovir would reduce the risk of HIV-1 acquisition. We undertook a double-blind, randomised, placebo-controlled phase III trial in HIV-negative, HSV-2 seropositive women in Africa and men who have sex with men (MSM) from sites in Peru and the USA. Participants were randomly assigned by block randomisation to twice daily aciclovir 400 mg (n=1637) or matching placebo (n=1640) for 12-18 months, and were seen monthly for dispensation of study drug, adherence counselling and measurement by pill count and self-reporting, and risk reduction counselling, and every 3 months for genital examination and HIV testing. The primary outcome was HIV-1 acquisition and secondary was incidence of genital ulcers. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00076232. 3172 participants (1358 women, 1814 MSM) were included in the primary dataset (1581 in aciclovir group, 1591 in control group). The incidence of HIV-1 was 3.9 per 100 person-years in the aciclovir group (75 events in 1935 person-years of follow-up) and 3.3 per 100 person-years in the placebo group (64 events in 1969 person-years of follow-up; hazard ratio 1.16 [95% CI 0.83-1.62]). Incidence of genital ulcers on examination was reduced by 47% (relative risk 0.53 [0.46-0.62]) and HSV-2 positive genital ulcers by 63% (0.37 [0.31-0.45]) in the aciclovir group. Adherence to dispensed study drug was 94% in the aciclovir group and 94% in the placebo group, and 85% of expected doses in the aciclovir group and 86% in the placebo group. Retention was 85% at 18 months in both groups (1028 of 1212 in aciclovir group, 1030 of 1208 in placebo group). We recorded no serious events related to the study drug. Our results show that suppressive therapy with standard doses of aciclovir is not effective in reduction of HIV-1 acquisition in HSV-2 seropositive women and MSM. Novel strategies are needed to interrupt interactions between HSV-2 and HIV-1.
            Article 0 comments Cited 100 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Invited commentary: a critical look at some popular meta-analytic methods.

              S Greenland (1994)
              Meta-analysis is essential for obtaining reproducible summaries of study results and valuable for discovering patterns among study results. A good meta-analysis will highlight and delineate the subjective components of these processes and vigorously search for sources of heterogeneity. Unfortunately, these objective are not always met by common techniques. For example, a scatterplot is an objective summarization if the data are uncensored, but inferred patterns should be regarded as subjective recognitions of the analyst, not objective data properties. Random-effects summaries encourage averaging over important data patterns, divert attention from key sources of heterogeneity, and can amplify distortions produced by publication bias; such summaries should only be used when important heterogeneity remains after a thorough search for the sources of such heterogeneity. Quality scoring adds the analyst's subjective bias to the results, wastes information, and can prevent the recognition of key sources of heterogeneity; it should be completely replaced by meta-regression on quality items (the score components).
              Article 0 comments Cited 80 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (iso-abbrev): PLoS Med
                Title: PLoS medicine
                Publisher: Public Library of Science (PLoS)
                ISSN (Electronic): 1549-1676
                ISSN (Print): 1549-1277
                Publication date (Electronic): Feb 2014
                Volume: 11
                Issue: 2
                Affiliations
                [1 ] Department of Global Health, University of Washington, Seattle, Washington, United States of America.
                [2 ] Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.
                [3 ] Department of Global Health, University of Washington, Seattle, Washington, United States of America ; Department of Biostatistics, University of Washington, Seattle, Washington, United States of America ; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
                [4 ] Department of Global Health, University of Washington, Seattle, Washington, United States of America ; Department of Epidemiology, University of Washington, Seattle, Washington, United States of America ; Department of Medicine, University of Washington, Seattle, Washington, United States of America ; Department of Pediatrics, University of Washington, Seattle, Washington, United States of America.
                Article
                Publisher Item ID: PMEDICINE-D-13-02644
                DOI: 10.1371/journal.pmed.1001608
                PMC ID: 3934828
                PubMed ID: 24586123
                SO-VID: 77118cc2-108a-4ff3-9598-88d630303b0b
                History

                Data availability:

                Comments

                Comment on this article

                scite_

                Similar content69

                See all similar

                Cited by183

                See all cited by

                Most referenced authors450

                See all reference authors