Maternal Syphilis Leading to High Efficiency In Utero Transmission of Antiretroviral Resistant HIV: Intersection of Two Pandemics.

IF 2.9 4区医学 Q3 IMMUNOLOGY

Pediatric Infectious Disease Journal Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI:10.1097/INF.0000000000004414

James Homans, Carla Blieden

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引用次数: 0

Abstract

Background: Testing for syphilis and HIV is indicated in prenatal care in the United States. Effective antiretroviral therapy during pregnancy reduces mother-to-child HIV transmission (MTCT) to less than 1%. Syphilis infection in pregnant women with unsuppressed HIV increases the risk of MTCT, usually in utero. The incidences of syphilis in women of childbearing age and corresponding congenital syphilis are increasing in the United States.

Methods: We report 3 cases of in utero HIV transmission associated with maternal syphilis that occurred during the ongoing syphilis epidemic.

Results: All 3 women had untreated HIV infection and active syphilis with placentitis during late pregnancy. Their newborns were found to have symptomatic congenital syphilis and HIV infection from in utero transmission. The babies' antiretroviral resistance patterns were nearly identical to their mothers'.

Conclusions: When untreated syphilis and uncontrolled HIV coincide in pregnancy, there is a high likelihood of in utero mother-to-child HIV transmission. The current syphilis epidemic in the United States may lead to an increase in MTCT.

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孕产妇梅毒导致抗逆转录病毒耐药艾滋病病毒在子宫内的高效传播：两种流行病的交汇。

背景：在美国，梅毒和艾滋病病毒检测是产前护理的一项指标。孕期有效的抗逆转录病毒治疗可将母婴艾滋病传播率（MTCT）降至1%以下。艾滋病毒未得到抑制的孕妇感染梅毒会增加母婴传播的风险，通常是在子宫内。在美国，育龄妇女的梅毒发病率和相应的先天性梅毒发病率正在上升：我们报告了 3 例在梅毒流行期间发生的与母体梅毒相关的子宫内 HIV 传播病例：结果：这3名妇女均在妊娠晚期感染了未经治疗的艾滋病病毒，并患有活动性梅毒和胎盘炎。她们的新生儿被发现患有无症状的先天性梅毒，并因子宫内传播而感染了艾滋病病毒。婴儿的抗逆转录病毒耐药模式与母亲几乎相同：结论：当未经治疗的梅毒和未得到控制的艾滋病病毒同时出现在妊娠期时，母婴传播艾滋病病毒的可能性很大。美国目前的梅毒疫情可能会导致母婴传播的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Infectious Disease Journal 医学-传染病学

CiteScore

6.30

自引率

2.80%

发文量

566

审稿时长

2-4 weeks

期刊介绍： The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.