RESUMO
(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (<100 copies/mL 2 occasions before or after pregnancy off ART). (2) Methods: A multi-centre, retrospective case series (1999-2021) comparing pre- and post-2012 when guidelines departed from zidovudine-monotherapy (ZDVm) as a first-line option. Demographic, virologic, obstetric and neonatal information were anonymised, collated and analysed in SPSS. (3) Results: A total of 49 live births were recorded in 29 women, 35 pre-2012 and 14 post. HIV infection was more commonly diagnosed in first reported pregnancy pre-2012 (15/35) compared to post (2/14), p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28/35) with pre-labour caesarean section (PLCS) (24/35). Post-2012 4/14 received ZDVm and 10/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11/35 deliveries pre-2012. During pregnancy, HIV was detected (> 50 copies/mL) in 14/49 pregnancies (29%) (median 92, range 51-6084). Neonatal ZDV post-exposure prophylaxis was recorded for 45/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates.
Assuntos
Educação Profissional em Saúde Pública/métodos , Pandemias/prevenção & controle , Saúde Sexual/educação , COVID-19/epidemiologia , COVID-19/prevenção & controle , Instrução por Computador , Educação a Distância , Humanos , Avaliação de Programas e Projetos de Saúde , Reino Unido/epidemiologiaAssuntos
Infecções por HIV/diagnóstico , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Adolescente , Adulto , Feminino , Infecções por HIV/complicações , Anticorpos Anti-Hepatite B/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica , VacinaçãoRESUMO
Lymphogranuloma venereum in the United Kingdom was detected in 2004, following the introduction of enhanced surveillance. This report describes a previously undiagnosed case, detected retrospectively in a sample obtained in 2003 from a male patient with high-risk behaviour, indicating that this previously rare disease in Europe, was present in the UK in 2003.