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Find video protocols related to scientific articles indexed in Pubmed.
Incidence of pregnancy after antiretroviral therapy initiation and associated factors in 8 West African countries.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 09-13-2014
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This study aimed at estimating the incidence of pregnancy after antiretroviral therapy (ART) initiation in 8 West African countries over a 10-year period.
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Antiretroviral therapy response among HIV-2 infected patients: a systematic review.
BMC Infect. Dis.
PUBLISHED: 08-26-2014
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Few data are available on antiretroviral therapy (ART) response among HIV-2 infected patients. We conducted a systematic review on treatment outcomes among HIV-2 infected patients on ART, focusing on the immunological and virological responses in adults.
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Re-testing and misclassification of HIV-2 and HIV-1&2 dually reactive patients among the HIV-2 cohort of the West African Database to evaluate AIDS collaboration.
J Int AIDS Soc
PUBLISHED: 08-11-2014
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West Africa is characterized by the circulation of HIV-1 and HIV-2. The laboratory diagnosis of these two infections as well as the choice of a first-line antiretroviral therapy (ART) is challenging, considering the limited access to second-line regimens. This study aimed at confirming the classification of HIV-2 and HIV-1&2 dually reactive patients followed up in the HIV-2 cohort of the West African Database to evaluate AIDS collaboration.
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Acceptabilité du test VIH proposé aux nourrissons dans les services pédiatriques, en Côte d'Ivoire, Significations pour la couverture du diagnostic pédiatrique.
SAHARA J
PUBLISHED: 08-05-2014
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Résumé Problème: Le dépistage VIH chez les enfants a rarement été au centre des préoccupations des chercheurs. Quand le dépistage pédiatrique a retenu l'attention, cela a été pour éclairer seulement sur les performances diagnostiques en ignorant même que le test pédiatrique comme bien d'autres peut s'accepter ou se refuser. Cet article met au cœur de son analyse les raisons qui peuvent expliquer qu'on accepte ou qu'on refuse de faire dépister son enfant. Objectif: Etudier chez les parents, les mères, les facteurs explicatifs de l'acceptabilité du test VIH des nourrissons de moins de six mois. Méthodes: Entretien semi-directif à passages répétés avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pesée/vaccination et les consultations pédiatriques avec proposition systématique d'un test VIH pour leur nourrisson. Résultats: Nous retenons que la réalisation effective du test pédiatrique du VIH chez le nourrisson repose sur trois éléments. Primo, le personnel de santé par son discours (qui dénote de ses connaissances et perceptions même sur l'infection) orienté vers les mères influence leur acceptation ou non du test. Secundo, la mère qui par ses connaissances et perceptions même sur le VIH, dont le statut particulier, l'impression de bien-être chez elle et son enfant influence toute réalisation du test pédiatrique VIH. Tertio, l'environnement conjugal de la mère, particulièrement caractérisé par les rapports au sein du couple, sur la facilité de parler du test VIH et sa réalisation chez les deux parents ou chez la mère seulement sont autant de facteurs qui influencent la réalisation effective du dépistage du VIH chez l'enfant. Le principe préventif du VIH, et le désir de faire tester l'enfant ne suffisent pas à eux seuls pour aboutir à sa réalisation effective, selon certaines mères confrontées au refus du conjoint. A l'opposé, les autres mères refusant la réalisation du test pédiatrique disent s'y opposer ; bien entendu, même dans le cas où le conjoint l'accepterait. Discussion: Les mères sont les principales mises en cause et craignent les réprimandes et la stigmatisation. Le père, le conjoint peut être un obstacle, quand il s'oppose au test VIH du nourrisson, ou devenir le facilitateur de sa réalisation s'il est convaincu. Le positionnement du père demeure donc essentiel dans la question de l'acceptabilité du VIH pédiatrique. Les mères en ont conscience et présagent des difficultés à faire dépister ou non les enfants sans avis préalable du conjoint à la fois père, et chef de famille. Conclusion: La question du dépistage pédiatrique du VIH, au terme de notre analyse, met en face trois éléments qui exigent une gestion globale pour assurer une couverture effective. Ces trois éléments n'existeraient pas sans s'influencer, donc ils sont constamment en interaction et empêchent ou favorisent la réalisation ou non du test pédiatrique. Aussi, dans une intention d'aboutir à une couverture effective du dépistage VIH des nourrissons, faut-il tenir compte d'une gestion harmonieuse de ces trois éléments: La première, la mère seule (avec ses connaissances, ses perceptions), son environnement conjugal (de proposition du test intégrant 1- l'époux et / ou père de l'enfant avec ses perceptions et connaissances sur l'infection 2- la facilité de parler du test et sa réalisation chez les deux ou un des parents, la mère) et les connaissances, attitudes et pratiques du personnel de l'établissement sanitaire sur l'infection du VIH. Recommandations: Nos recommandations proposent une redéfinition de l'approche du VIH/sida vers des familles exposées au VIH et une intégration plus accentuée du père facilitant leur propre acceptation du test VIH et celle de leur enfant.
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Cervical cancer prevention in reproductive health services: knowledge, attitudes and practices of midwives in Côte d'Ivoire, West Africa.
BMC Health Serv Res
PUBLISHED: 04-04-2014
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Cervical cancer is the most common cancer among women and the leading cause of cancer deaths in women in Côte d'Ivoire. Low resource countries can now prevent this cancer by using HPV vaccine and effective and affordable screening tests. However the implementation of these prevention strategies needs well-trained human resources. Part of the solution could come from midwives by integrating cervical cancer prevention into reproductive health services. The aim of this survey was to assess knowledge, attitudes and practices of midwives towards cervical cancer prevention in Abidjan, Côte d'Ivoire, and to find out factors associated with appropriate knowledge.
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Genotypic resistance profiles of HIV-2-treated patients in West Africa.
AIDS
PUBLISHED: 03-04-2014
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To assess the virological response, genotypic resistance profiles, and antiretroviral plasma concentrations in HIV-2 antiretroviral-treated (antiretroviral therapy, ART) patients in Côte d'Ivoire.
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Oral lesions among HIV-infected children on antiretroviral treatment in West Africa.
Trop. Med. Int. Health
PUBLISHED: 01-06-2014
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To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infected children receiving antiretroviral treatment (ART) in West Africa and to identify the factors associated with the prevalence of oral mucosal lesions.
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Antiretroviral treatment response of HIV-infected children after prevention of mother-to-child transmission in West Africa.
J Int AIDS Soc
PUBLISHED: 01-01-2014
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We assessed the rate of treatment failure of HIV-infected children after 12 months on antiretroviral treatment (ART) in the Paediatric IeDEA West African Collaboration according to their perinatal exposure to antiretroviral drugs for preventing mother-to-child transmission (PMTCT).
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Intimate partner sexual and physical violence among women in Togo, West Africa: prevalence, associated factors, and the specific role of HIV infection.
Glob Health Action
PUBLISHED: 01-01-2014
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A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence.
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Risk factors for cervical intraepithelial neoplasia in HIV-infected women on antiretroviral treatment in Côte d'Ivoire, West Africa.
PLoS ONE
PUBLISHED: 01-01-2014
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Facing the dual burden of invasive cervical cancer and HIV in sub-Saharan Africa, the identification of preventable determinants of Cervical Intraepithelial Neoplasia (CIN) in HIV-infected women is of paramount importance.
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Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso.
J Int AIDS Soc
PUBLISHED: 09-18-2013
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Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods: HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results: A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30-44] and their median CD4 count was 181 cells/mm(3) (IQR 97-269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p
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Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS.
J Int AIDS Soc
PUBLISHED: 08-09-2013
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There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART) containing zidovudine (ZDV) recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database.
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Measuring coverage in MNCH: population HIV-free survival among children under two years of age in four African countries.
PLoS Med.
PUBLISHED: 05-01-2013
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Population-based evaluations of programs for prevention of mother-to-child HIV transmission (PMTCT) are scarce. We measured PMTCT service coverage, regimen use, and HIV-free survival among children ?24 mo of age in Cameroon, Côte DIvoire, South Africa, and Zambia.
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Universal HIV screening at postnatal points of care: which public health approach for early infant diagnosis in Côte dIvoire?
PLoS ONE
PUBLISHED: 01-01-2013
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Universal HIV pediatric screening offered at postnatal points of care (PPOC) is an entry point for early infant diagnosis (EID). We assessed the parents acceptability of this approach in Abidjan, Côte dIvoire.
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Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.
Didier K Ekouevi, Eric Balestre, Patrick A Coffie, Daouda Minta, Eugène Messou, Adrien Sawadogo, Albert Minga, Papa Salif Sow, Emmanuel Bissagnéné, Serge P Eholie, Geoffrey S Gottlieb, Francois Dabis, , Djimon Marcel Zannou, Carin Ahouada, Jocelyn Akakpo, Christelle Ahomadegbé, Jules Bashi, Alice Gougounon-Houéto, Angèle Azon-Kouanou, Fabien Houngbe, Sikiratou Koumakpaï, Florence Alihonou, Marcelline d'Almeida, Irvine Hodonou, Ghislaine Hounhoui, Gracien Sagbo, Leïla Tossa-Bagnan, Herman Adjide, Joseph Drabo, René Bognounou, Arnaud Dienderé, Eliezer Traore, Lassané Zoungrana, Béatrice Zerbo, Adrien Bruno Sawadogo, Jacques Zoungrana, Arsène Hema, Ibrahim Soré, Guillaume Bado, Achille Tapsoba, Diarra Ye, Fla Koueta, Sylvie Ouedraogo, Rasmata Ouédraogo, William Hiembo, Mady Gansonré, Joachim Charles Gnokoro, Mamadou Koné, Guillaume Martial Kouakou, Clarisse Amani Bosse, Kouakou Brou, Achi Isidore Assi, Henri Chenal, Denise Hawerlander, Franck Soppi, Yao Abo, Germain Bomisso, Serge Paul Eholié, Mensah Deborah Noelly Amego, Viviane Andavi, Zelica Diallo, Frédéric Ello, Aristophane Koffi Tanon, Serge Olivier Koule, Koffi Charles Anzan, Calixte Guehi, Edmond Addi Aka, Koffi Ladji Issouf, Jean-Claude Kouakou, Marie-Sylvie N'gbeche, Pety Touré, Divine Avit-Edi, Kouadio Kouakou, Magloire Moh, Valérie Andoblé Yao, Madeleine Amorissani Folquet, Marie-Evelyne Dainguy, Cyrille Kouakou, Véronique Tanoh Méa-Assande, Gladys Oka-Berete, Nathalie Zobo, Patrick Acquah, Marie-Berthe Kokora, Tanoh François Eboua, Marguerite Timite-Konan, Lucrèce Diecket Ahoussou, Julie Kebé Assouan, Mabéa Flora Sami, Clémence Kouadio, Lorna Renner, Bamenla Goka, Jennifer Welbeck, Adziri Sackey, Seth Ntiri Owiafe, Christian Wejse, Zacarias José da Silva, Joao Paulo, Amabelia Rodrigues, David Da Silva, Candida Medina, Ines Oliviera-Souto, Lars Ostergaard, Alex Laursen, Morten Sodemann, Peter Aaby, Anders Fomsgaard, Christian Erikstrup, Jesper Eugen-Olsen, Moussa Y Maiga, Fatoumata Fofana Diakité, Abdoulaye Kalle, Drissa Katile, Hamar Alassane Traore, Tidiani Cissé, Mamadou Dembele, Mohammed Doumbia, Mahamadou Fomba, Assétou Soukho Kaya, Abdoulaye M Traoré, Hamady Traoré, Amadou Abathina Toure, Fatoumata Dicko, Mariam Sylla, Alima Berthé, Hadizatou Coulibaly Traoré, Anta Koïta, Niaboula Koné, Clémentine N'diaye, Safiatou Touré Coulibaly, Mamadou Traoré, Naïchata Traoré, Man Charurat, Samuel Ajayi, Stephen Dapiap, Otu, Festus Igbinoba, Okwara Benson, Clement Adebamowo, Jesse James, Obaseki, Philip Osakede, John Olasode, Bernard Diop, Noël Magloire Manga, Judicael Malick Tine, Haby Signate Sy, Abou Ba, Aida Diagne, Hélène Dior, Malick Faye, Ramatoulaye Diagne Gueye, Aminata Diack Mbaye, Akessiwe Patassi, Awerou Kotosso, Benjamin Goilibe Kariyare, Gafarou Gbadamassi, Agbo Komi, Kankoé Edem Mensah-Zukong, Pinuwe Pakpame, Annette Koko Lawson-Evi, Yawo Atakouma, Elom Takassi, Améyo Djeha, Ayoko Ephoévi-Gah, Sherifa El-Hadj Djibril, Elise Arrivé, Patrick Coffie, Didier Ekouévi, Antoine Jaquet, Valériane Leroy, Charlotte Lewden, Annie Sasco, Jean-Claude Azani, Gérard Allou, Franck Bohossou, Sophie Karcher, Jules Mahan Gonsan, Jérôme Le Carrou, Severin Lenaud, Célestin Nchot, Karen Malateste, Amon Roseamonde Yao, Bertine Siloué, Gwenaelle Clouet, Hugues Djetouan, Alexandra Doring, Adrienne Kouakou, Elodie Rabourdin, Jean Rivenc, Xavier Anglaret, Boubacar Ba, Jean Bosco Essanin, Andrea Ciaranello, Sébastien Datté, Sophie Desmonde, Jean-Serge Elvis Diby, Apollinaire Gninlgninrin Horo, Serge N'zoré Kangah, Denis Malvy, David Meless, Aida Mounkaila-Harouna, Camille Ndondoki, Caroline Shiboski, Rodolphe Thiébaut, Pac-Ci, Abidjan.
PLoS ONE
PUBLISHED: 01-01-2013
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HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).
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Nevirapine for the prevention of mother-to-child transmission of HIV: a nation-wide coverage survey in Côte dIvoire.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 08-23-2011
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Single-dose nevirapine (NVP) is the simplest antiretroviral regimen for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. We evaluated NVP coverage among HIV-infected delivering women in Côte dIvoire.
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12-month mortality and loss-to-program in antiretroviral-treated children: The IeDEA pediatric West African Database to evaluate AIDS (pWADA), 2000-2008.
BMC Public Health
PUBLISHED: 06-30-2011
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The IeDEA West Africa Pediatric Working Group (pWADA) was established in January 2007 to study the care and treatment of HIV-infected children in this region. We describe here the characteristics at antiretroviral treatment (ART) initiation and study the 12-month mortality and loss-to-program of HIV-infected children followed in ART programs in West Africa.
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Strengthening health systems through HIV monitoring and evaluation in Sub-Saharan Africa.
Curr Opin HIV AIDS
PUBLISHED: 05-07-2011
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In this review, we describe the challenges faced by using clinical cohorts to perform Monitoring and Evaluation (M&E) and the possible solutions for increasing and strengthening health systems in low-income and middle-income countries.
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Coverage of intermittent prevention treatment with sulphadoxine-pyrimethamine among pregnant women and congenital malaria in Côte dIvoire.
Malar. J.
PUBLISHED: 04-29-2011
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The World Health Organization (WHO) recommends using insecticide-treated mosquito nets (ITNs) and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP) to prevent malaria in sub-Saharan Africa. Data on IPT-SP coverage and factors associated with placental malaria parasitaemia and low birth weight (LBW) are scarce in Côte dIvoire.
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Plasma and intracellular tenofovir pharmacokinetics in the neonate (ANRS 12109 trial, step 2).
Antimicrob. Agents Chemother.
PUBLISHED: 04-04-2011
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The objective of this study was to investigate for the first time tenofovir (TFV) pharmacokinetics in plasma and peripheral blood mononuclear cells (PBMCs) of the neonate. HIV-1-infected pregnant women received two tablets of tenofovir disoproxil fumarate (TDF; 300 mg) and emtricitabine (FTC; 200 mg) at onset of labor and then one tablet daily for 7 days postpartum. A single dose of 13 mg/kg of body weight of TDF was administered to 36 neonates within 12 h of life after the HIV-1-infected mothers had been administered two tablets of TDF-emtricitabine at delivery. A total of 626 samples collected within the 2 days after the drug administration were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and analyzed by a population approach. In the neonate, the median TFV plasma area under the curve and minimal and maximal concentrations, respectively, were 3.73 mg/liter · h and 0.076 and 0.29 mg/liter. In PBMCs, TFV concentrations were detectable in all fetuses, whereas tenofovir diphosphate (TFV-DP) was quantifiable in only two fetuses, suggesting a lag in appearance of TFV-DP. The median TFV-DP neonatal concentration was 146 fmol/10? cells (interquartile range [IQR], 53 to 430 fmol/10? cells); two neonates had very high TFV-DP concentrations (1,530 and 2963 fmol/10? cells). The 13-mg/kg TDF dose given to neonates produced plasma TFV and intracellular active TFV-DP concentrations similar to those in adults. This dose should be given immediately after birth to reduce the delay before the active compound TFV-DP appears in cells.
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Very high concentrations of active intracellular phosphorylated emtricitabine in neonates (ANRS 12109 trial, step 2).
Antimicrob. Agents Chemother.
PUBLISHED: 04-04-2011
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Our objective was to investigate neonatal emtricitabine (FTC) plasma and intracellular pharmacokinetics. The study was designed as a phase I/II prospective trial in two sequential steps evaluating the combination of tenofovir disoproxil fumarate (TDF) and FTC for the prevention of mother-to-child-transmission (PMTCT) of HIV. HIV-1-infected pregnant women received two tablets of TDF (300 mg) and FTC (200 mg) at onset of labor and then one tablet daily for 7 days postpartum. Based on the data obtained in the first part of the Tenofovir/Emtricitabine in Africa and Asia (TEmAA) Study, single doses of 2 mg/kg of FTC and 13 mg/kg of TDF were given to the neonates within 12 h after birth. A total of 540 FTC plasma concentrations and 44 active intracellular phosphorylated metabolite FTC-TP concentrations were taken from the 36 enrolled women and their neonates. Concentrations were measured by the liquid chromatography-tandem mass spectrometry (LC-MS/MS) method and analyzed by a population approach. The proposed dose obtained by simulations based on plasma drug concentrations was confirmed. However, median FTC-TP exposures were, respectively, 5.9 and 6.8 times higher in the fetus and the neonate than in the adult. High FTC-TP concentrations were observed in the four children who had serious adverse events (SAEs), but the link between FTC-TP concentrations and SAEs in children was not formally identified. The exposure to the active form of FTC was high in neonates despite plasma drug concentrations equivalent to those in adults. Our results are similar to those obtained with zidovudine or lamivudine.
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Pregnancy outcomes in women exposed to efavirenz and nevirapine: an appraisal of the IeDEA West Africa and ANRS Databases, Abidjan, Côte dIvoire.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 02-17-2011
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An increasing number of HIV-infected women become pregnant while receiving efavirenz (EFV). We compared the pregnancy outcomes of women exposed to EFV and to nevirapine (NVP) during the first trimester.
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[Survival, clinical and biological outcomes of HIV-infected children treated by antiretroviral therapy in Africa: systematic review, 2004-2009].
Presse Med
PUBLISHED: 02-03-2011
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With 2.1 million HIV-infected children in 2008 in the world, especially in sub-Saharan Africa, the paediatric HIV/AIDS care remains an important public health challenge and is principally based on cotrimoxazole prophylaxis and antiretroviral treatments. This paper aims to review the effectiveness of cotrimoxole prophylaxis and antiretroviral treatment in HIV-infected children in Africa, specifically mortality and treatment outcomes.
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Pharmacovigilance for antiretroviral drugs in Africa: lessons from a study in Abidjan, Cote dIvoire.
Pharmacoepidemiol Drug Saf
PUBLISHED: 01-25-2011
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Although antiretroviral treatment (ART)-related adverse drug reactions (ADR) are documented in industrialised countries, there is no pre-existing surveillance system dedicated to ADR monitoring in most African countries. We assessed knowledge towards pharmacovigilance among ART prescribers and available capacity of HIV clinics to conduct ADR monitoring in Abidjan, Côte dIvoire.
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Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa.
Int J Epidemiol
PUBLISHED: 01-18-2011
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Previously, HIV epidemic models have used a double Weibull curve to represent high initial and late mortality of HIV-infected children, without distinguishing timing of infection (peri- or post-natally). With more data on timing of infection, which may be associated with disease progression, a separate representation of children infected early and late was proposed.
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Concentrations of tenofovir and emtricitabine in breast milk of HIV-1-infected women in Abidjan, Cote dIvoire, in the ANRS 12109 TEmAA Study, Step 2.
Antimicrob. Agents Chemother.
PUBLISHED: 12-20-2010
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The aim was to evaluate emtricitabine (FTC) and tenofovir (TFV) neonatal ingestion through breast milk. Median TFV and FTC breast milk doses represented 0.03% and 2%, respectively, of the proposed oral infant doses. Neonatal simulated plasma concentrations were extremely low for TFV but between the half-maximal inhibitory concentration and the adult minimal expected concentration for FTC. The rare children who will acquire HIV despite TDF-FTC therapy will need to be monitored for viral resistance acquisition.
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Population pharmacokinetics of nevirapine in HIV-1-infected pregnant women and their neonates.
Antimicrob. Agents Chemother.
PUBLISHED: 10-18-2010
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The aim of the present study was to describe the nevirapine (NVP) pharmacokinetics (PK) in pregnant women and their neonates and to evaluate the transplacental drug transfer and administration scheme for the prevention of mother-to-child transmission. Thirty-eight HIV-1-infected pregnant women were administered one tablet of NVP (200 mg) and two tablets of tenofovir-emtricitabine (Truvada) at the initiation of labor. Children were given NVP syrup (2 mg/kg of body weight) as a single dose (sdNVP) on the first day of life. By pair, NVP concentrations were measured in 11 maternal, 1 cord blood, and 2 neonatal plasma samples and analyzed by a population approach. A one-compartment model was used for mothers and neonates; the absorption rate constants for mothers and neonates were 0.95 h(-1) (intersubject variability, 111%) and 0.39 h(-1), respectively; the apparent elimination clearances were 1.42 liter·h(-1) (intersubject variability, 22%) and 0.035 liter·h(-1), respectively; and apparent volumes of distribution were 87.3 liters (intersubject variability, 25%) and 5.65 liters, respectively. An effect compartment was linked to maternal circulation by mother-to-cord and cord-to-mother rate constants of 1.10 h(-1) and 1.43 h(-1), respectively. Placental transfer, expressed as the fetal-to-maternal area under the curve ratio, was 75%. Neonates had a very long half-lives (110 h) compared to adults. In the 38 mothers, the simulated median individual predicted time during which the NVP concentration remained above the half-maximal inhibitory concentration (IC(50)) was 13.2 days (range, 12 to 19.2 days). Thus, the administration of tenofovir-emtricitabine for at least 3 weeks after delivery should be considered to prevent the emergence of resistant viruses. The neonate must receive sdNVP immediately after birth when the infant is born less than 30 min after maternal drug intake to keep NVP concentrations above the IC(50).
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Maternal and nenonatal tenofovir and emtricitabine to prevent vertical transmission of HIV-1: tolerance and resistance.
AIDS
PUBLISHED: 09-10-2010
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Viral resistance occurs with a high frequency after single-dose nevirapine. We aimed to evaluate the tolerance and resistance profiles of a combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) given to HIV-1-infected delivering women and their newborns.
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Immunological response to highly active antiretroviral therapy following treatment for prevention of mother to child transmission of HIV-1: a study in Côte dIvoire.
J Int AIDS Soc
PUBLISHED: 08-02-2010
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Information is currently limited on the long-term follow up of HIV-1 infected women who are on highly active antiretroviral therapy (HAART) that contains nevirapine and lamivudine and who were previously exposed to antiretroviral drugs for the prevention of mother to child transmission (PMTCT) of HIV.
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Coverage of nevirapine-based services to prevent mother-to-child HIV transmission in 4 African countries.
JAMA
PUBLISHED: 07-20-2010
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Few studies have objectively evaluated the coverage of services to prevent transmission of human immunodeficiency virus (HIV) from mother to child.
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Incidence and risk factors of severe adverse events with nevirapine-based antiretroviral therapy in HIV-infected women. MTCT-Plus program, Abidjan, Côte dIvoire.
BMC Infect. Dis.
PUBLISHED: 06-24-2010
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In resource-limited settings where nevirapine-containing regimen is the preferred regimen in women, data on severe adverse events (SAEs) according to CD4 cell count are limited. We estimated the incidence of SAEs according to CD4 cell count and identify their risk factors in nevirapine-treated women.
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Alcohol use and non-adherence to antiretroviral therapy in HIV-infected patients in West Africa.
Addiction
PUBLISHED: 06-07-2010
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To investigate the association between alcohol use and adherence to highly active antiretroviral treatment (HAART) among human immunodeficiency virus (HIV)-infected patients in sub-Saharan Africa.
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First-year lymphocyte T CD4+ response to antiretroviral therapy according to the HIV type in the IeDEA West Africa collaboration.
AIDS
PUBLISHED: 04-17-2010
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To compare the lymphocyte T CD4+ (CD4) response to combinations of antiretroviral therapy (ART) in HIV-1, HIV-2 and dually positive patients in West Africa.
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The challenge of AIDS-related malignancies in sub-Saharan Africa.
PLoS ONE
PUBLISHED: 01-11-2010
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With the lengthening of life expectancy among HIV-positive subjects related to the use of highly active antiretroviral treatments, an increased risk of cancer has been described in industrialized countries. The question is to determine what occurs now and will happen in the future in the low income countries and particularly in sub-Saharan Africa where more than two-thirds of all HIV-positive people live in the world. The objective of our paper is to review the link between HIV and cancer in sub-Saharan Africa, putting it in perspective with what is already known in Western countries.
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Universal antiretroviral therapy for pregnant and breast-feeding HIV-1-infected women: towards the elimination of mother-to-child transmission of HIV-1 in resource-limited settings.
Clin. Infect. Dis.
PUBLISHED: 11-18-2009
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Prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) remains a challenge in most resource-limited settings, particularly in Africa. Single-dose and short-course antiretroviral (ARV) regimens are only partially effective and have failed to achieve wide coverage despite their apparent simplicity. More potent ARV combinations are restricted to pregnant women who need treatment for themselves and are also infrequently used. Furthermore, postnatal transmission via breast-feeding is a serious additional threat. Modifications of infant feeding practices aim to reduce HIV-1 transmission through breast milk; replacement feeding is neither affordable nor safe for the majority of African women, and early breast-feeding cessation (eg, prior to 6 months of life) requires substantial care and nutritional counseling to be practiced safely. The recent roll out of ARV treatment has changed the paradigm of prevention of MTCT. To date, postnatal ARV interventions that have been evaluated target either maternal ARV treatment to selected breast-feeding women, with good efficacy, or single-drug postexposure prophylaxis for short periods of time to their neonates, with a partial efficacy and at the expense of acquisition of drug-related viral resistance. We hypothesize that a viable solution to eliminate pediatric AIDS lies in the universal provision of fully suppressive ARV regimens to all HIV-1-infected women through pregnancy, delivery, and the entire breast-feeding period. On the basis of available evidence, we suggest translating into practice the recently available evidence on this matter without any further delay.
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Beneficial effects of offering prenatal HIV counselling and testing on developing a HIV preventive attitude among couples. Abidjan, 2002-2005.
AIDS Behav
PUBLISHED: 09-24-2009
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Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Côte dIvoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIV-infected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the womens serostatus and even in the case of test refusal. Spousal communication was related to more frequent male partner HIV-testing and condom use. Prenatal HIV counselling and testing proposal appears to be an efficient tool to sensitize women and their partner to safer sexual practices.
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Duration, pattern of breastfeeding and postnatal transmission of HIV: pooled analysis of individual data from West and South African cohorts.
PLoS ONE
PUBLISHED: 06-26-2009
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Both breastfeeding pattern and duration are associated with postnatal HIV acquisition; their relative contribution has not been reliably quantified.
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Population pharmacokinetics of emtricitabine in human immunodeficiency virus type 1-infected pregnant women and their neonates.
Antimicrob. Agents Chemother.
PUBLISHED: 05-20-2009
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The objectives of this study were to evaluate emtricitabine (FTC) pharmacokinetics in pregnant women and their neonates and to determine the optimal prophylactic dose for neonates after birth to prevent mother-to-child transmission of human immunodeficiency virus (HIV). A total of 38 HIV-infected pregnant women were administered tenofovir disoproxyl fumarate (300 mg)-FTC (200 mg) tablets-two tablets at the initiation of labor and one daily for 7 days postpartum. By pair, 11 maternal, one cord blood, and two neonatal FTC concentrations were measured using a high-performance liquid chromatography-tandem mass spectrometry validated method and analyzed by a population approach. Model and mean estimates (interpatient variability) were a two-compartment model for mothers, with an absorption rate constant of 0.54 h(-1) (61%), apparent elimination and intercompartmental clearances of 23.2 (17%) and 6.04 liters x h(-1), and apparent central and peripheral volumes of 127 and 237 liters, respectively; an effect compartment linked to maternal circulation for cord blood and a neonatal compartment disconnected, after delivery, with a 10.6-h half-life (30%). After the 400-mg FTC administration, the median population area under the concentration-time curve and the minimal and maximal plasma FTC concentrations in pregnant women were 14.3 mg x liter(-1) x h and 1.68 and 0.076 mg/liter, respectively. At delivery, median (range) predicted maternal and cord blood FTC concentrations were, respectively, 1.16 (0.14 to 1.99) and 0.72 (0.05 to 1.19) mg x liter(-1). We concluded that the 400-mg FTC administration in pregnant women produces higher exposition than does the 200-mg administration in other adults, at steady state. FTC was shown to have good placental transfer (80%). Administering 1 mg FTC/kg as soon as possible after birth or 2 mg/kg 12 h after birth should produce neonatal concentrations comparable to the concentrations observed in adults.
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Tolerance and viral resistance after single-dose nevirapine with tenofovir and emtricitabine to prevent vertical transmission of HIV-1.
AIDS
PUBLISHED: 03-25-2009
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Viral resistance occurs with high frequency after single-dose nevirapine. We aimed to evaluate the safety and resistance profiles of a combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) in HIV-1-infected pregnant women and their newborns.
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The spectrum of cancers in West Africa: associations with human immunodeficiency virus.
PLoS ONE
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Cancer is a growing co-morbidity among HIV-infected patients worldwide. With the scale-up of antiretroviral therapy (ART) in developing countries, cancer will contribute more and more to the HIV/AIDS disease burden. Our objective was to estimate the association between HIV infection and selected types of cancers among patients hospitalized for diagnosis or treatment of cancer in West Africa.
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Progress, challenges, and new opportunities for the prevention of mother-to-child transmission of HIV under the US Presidents Emergency Plan for AIDS Relief.
J. Acquir. Immune Defic. Syndr.
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In June 2011, the Joint United Nations Programme on HIV/AIDS, the US Presidents Emergency Plan for AIDS Relief (PEPFAR), and other collaborators outlined a transformative plan to virtually eliminate pediatric AIDS worldwide. The ambitious targets of this initiative included a 90% reduction in new pediatric HIV infections and a 50% reduction in HIV-related maternal mortality--all by 2015. PEPFAR has made an unprecedented commitment to the expansion and improvement of prevention of mother-to-child HIV transmission (PMTCT) services globally and is expected to play a critical role in reaching the virtual elimination target. To date, PEPFAR has been instrumental in the success of many national programs, including expanded coverage of PMTCT services, an enhanced continuum of care between PMTCT and HIV care and treatment, provision of more efficacious regimens for antiretroviral prophylaxis, design of innovative but simplified PMTCT approaches, and development of new strategies to evaluate program effectiveness. These accomplishments have been made through collaborative efforts with host governments, United Nations agencies, other donors (eg, the Global Fund for AIDS, Tuberculosis, and Malaria), nongovernmental organizations, and private sector partners. To successfully meet the ambitious global targets to prevent new infant HIV infections, PEPFAR must continue to leverage the existing PMTCT platform, while developing innovative approaches to rapidly expand quality HIV services. PEPFAR must also carefully integrate PMTCT into the broader combination prevention agenda for HIV, so that real progress can be made toward an "AIDS-free generation" worldwide.
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Feasibility and acceptability of rapid HIV screening in a labour ward in Togo.
J Int AIDS Soc
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HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa.
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HIV status disclosure and retention in care in HIV-infected adolescents on antiretroviral therapy (ART) in West Africa.
PLoS ONE
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We assessed the effect of HIV status disclosure on retention in care from initiation of antiretroviral therapy (ART) among HIV-infected children aged 10 years or more in Cote dIvoire, Mali and Sénégal.
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Cervical cancer screening by visual inspection in Côte dIvoire, operational and clinical aspects according to HIV status.
BMC Public Health
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Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed.
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Children who acquire HIV infection perinatally are at higher risk of early death than those acquiring infection through breastmilk: a meta-analysis.
PLoS ONE
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Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed.
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