PubMed · 8990461
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
J B Stanford. 1997. Measuring contraceptive effectiveness: a conceptual framework.. https://doi.org/10.1016/s0029-7844(97)84261-5
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: One of the remaining challenges in the prevention of mother-to-child transmission of HIV is to reduce the risk of the transmission during pregnancy. It remains to be investigated which factors affect intrauterine HIV transmission and how they can be identified and addressed during pregnancy. METHODS: Granulocyte elastase in the endocervical mucus of HIV-positive pregnant women in Zambia was measured, and its association with intrauterine transmission of HIV-1 from the mother to the fetus was investigated. RESULTS: The intrauterine transmission rate determined by polymerase chain reaction assay of DNA from neonates at birth was 15.3%. The risk for intrauterine transmission was 8.65-fold higher in women who were positive for granulocyte elastase than in those who were negative. CONCLUSION: We suggest that the women showing positive granulocyte elastase at delivery be strongly suspected of having and if having had chorioamnionitis during pregnancy, which could affect the intrauterine transmission of HIV.
OBJECTIVE: This study was conducted to evaluate the usefulness of testing for fetal fibronectin (fFN) to rule out the diagnosis of preterm labour in symptomatic patients in a Canadian setting. METHODS: This was a prospective, blinded clinical evaluation of fFN testing in women presenting with threatened preterm labour at between 24 and 34 weeks' gestation at two Canadian tertiary care centres. RESULTS: Of the 149 women tested, 32 had a positive fFN test. In the total patient population, 10.1% delivered within seven days of testing, and 18.2% delivered prior to 34 weeks. A negative fFN result was associated with a 97.4% likelihood of delivering more than seven days after testing and with a 91.4% chance of delivering after 34 weeks. CONCLUSION: The fFN test appears to provide useful information in the risk assessment of Canadian women presenting with symptoms compatible with preterm labour. A negative test has a high predictive value for delivering more than seven days after presentation.
OBJECTIVE: Although human immunodeficiency virus (HIV) infection is a well-known risk factor for cervical intraepithelial neoplasia (CIN), the influence of CIN on cervicovaginal shedding of HIV is poorly understood. The purpose of this study was to evaluate the association between CIN and the shedding of HIV in cervicovaginal secretions. METHODS: Two hundred sixteen HIV-seropositive patients were followed up by Pap test, colposcopy, and targeted cervical biopsies for a median of 16 months (range 0-94). A diagnosis of low-grade CIN was made on the basis of Pap test and either colposcopy or cervical biopsy. High-grade CIN was diagnosed solely on the basis of cervical biopsy. At each follow-up visit, we measured HIV-1 RNA in plasma, proviral HIV-1 DNA, and cell-associated and cell-free HIV-1 RNA in cervicovaginal secretion by competitive polymerase chain reaction (cRT-PCR) and reverse transcriptase PCR. The univariable and multivariable associations between the occurrence of CIN and the presence of HIV-related nucleic acids in cervicovaginal secretions were evaluated with logistic generalized estimating equations. RESULTS: Overall, at enrollment and during the follow-up period, a diagnosis of either low-grade or high-grade CIN was made in 14.4% (99/689) and 6.7% (46/689) of the visits, respectively. The presence of measurable levels of plasma HIV-1 RNA was a significant risk factor for the detection of cervicovaginal HIV-1 DNA (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.32-2.61, P < .001), cell-associated (OR 1.69, 95% CI 1.18-2.43, P = .004), and cell-free HIV-1 RNA (OR 1.84, 95% CI 1.28-2.63, P = .001). After the adjustment for the effect of plasma HIV-1 RNA, CD4(+) positive cell counts less than 200 mm(3), and bacterial vaginosis, the detection of cell-associated (OR 1.75, 95% CI 1.23-2.49, P = .006) and cell-free HIV-1 RNA (OR 2.0, 95% CI 1.39-2.87, P = .001) in cervicovaginal secretions was significantly associated with the diagnosis of CIN. CONCLUSION: The presence of CIN lesions is a significant risk factor for genital HIV shedding. Given the high prevalence of cervical disease among HIV-positive women, this finding could have important epidemiological implications in both heterosexual and perinatal transmission of HIV. LEVEL OF EVIDENCE: II-2.