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Mother-to-infant transmission of human immunodeficiency virus type 1: Association with prematurity or low anti-gp120
Citations from the Literature Mother-to-infant transmission of hnman immunodeficiency virus type 1: Association with prematurity or low anti-gpl20
Goedert J.J.; Drummond J.E.; Minkoff H.L.; Stevens R.; Blattner W.A.; Mendez H.; Robert-Guroff M.; Holman S.; Rubinstein A.; Willoughby A.; Landesman S.H. Viral Epidemiology Section, National Cancer Institute, 434 Executive Plaza North, Bethesda, MD 20892, USA LANCET 1989,2/8676(1X1-1354) In a prospective study of pregnant women infected with human immunodeficiency virus type 1 (HIV-l) in Brooklyn, New York, USA, 16 (29%) of 55 evaluable infants were infected with HIV-l. 9 infants had paediatric acquired immunodeficiency syndrome, 6 had less severe clinical manifestations of HIV-l infection, and 1 was symptom-free but was seropositive for HIV-l beyond 15 months of age. The 10 infants born at 37 weeks of gestation or earlier were at higher risk of HIV-l infection than infants born at 38 weeks of gestation or later (60@/0 vs 22%) but the median age at appearance of disease was approximately 5 months in the both groups. The HIV-l transmission rate was not associated with predelivery levels of maternal T cells, anti-p24, or neutralising antibodies but it was higher, among full-term infants, for those with mothers in the lowest third of the distribution of anti-gp120 levels (53%). On immunoblot, transmitting mothers lacked a gp120 band but not other bands. Protection was not associated with antibody to recombinant peptides from the hypervariable region of the major neutralising gpl20 epitope, and the antigpl20 endpoint dilution titre was similar in transmitting and non-transmitting mothers. Mothers of uninfected full-term infants appear to confer immunological protection against HIV-l infection of their offspring by way of a high-affinity antibody to a gpl20 epitope, whose specificity has importance possibly perinatal for vaccine development and immunotherapy.
Fetal death from chlamydiai infection across intact amniotic membranes
Thorp J.M. Jr.; Katz V.L.; Fowler L.J.; Kurtzman J.T.; Bowes W.A. Jr. Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hilt, NC 275997570, USA AM. J. OBSTET. GYNECOL., 1989, 161/5 (1245-1246) We report a case of a fetal death at 34 weeks’ gestation with intact membranes. An autopsy confirmed intrauterine pneumonia as a result of Chlamydia trachomatis. Staining of the lung tissue with a direct fluorescein-conjugated Chlamydiaspecific monoclonal antibody assay revealed a pattern typical of a Chlamydia trachomatis infection. This case supports the thesis that Chlamydia crosses fetal membranes and produces disease.
291
The effect of bacteriostatic lubricant on group B streptococcal cultures of the female genitai tract Brady K.;Sizem0reK.L.; Duff P.; Aamodt L.W.
Division of Maternal Fetal Medicine, Madigan Army Medical Center, Tacoma, WA 98431-5418, USA OBSTET. GYNECOL. 1989,74/6 (848-850) The purpose of this prospective investigation was to determine the effect of bacteriostatic lubricant on group B streptococcal cultures obtained from the lower genital tract of pregnant women. Fifty pregnant women with intact membranes who recently had genital tract cultures for group B streptococci were evaluated. The study group consisted of 25 women who had positive cultures, and the control group comprised 25 women who had negative cultures. All patients underwent examination with a sterile nonlubricated speculum within 7 days of the previously obtained cultures. Secretions from the endocervix and from the posterior vaginal wall near the introitus were collected with a sterile cotton-tipped applicator and inoculated directly onto a selective blood agar culture plate. The sterile speculum was removed and a digital examination performed using bacteriostatic lubricant. A second sterile speculum was then inserted into the vagina and another group B streptococcal culture was obtained. There was 100% correlation between the cultures obtained before and after the vaginal examination. We conclude that use of bacteriostatic lubricant does not alter the recovery of group B streptococci from the genital tract of pregnant women with intact membranes.
Human papiilomaviros DNA in fomites on objects used for the management of patients with genital human papillomavirus infections Ferenczy A.;Bergeron C.; Richart R.M.
Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, Que. H3TIE2, CAN OBSTET. GYNECOL. 1989,74/6 (950-954) We investigated the possibility that human papillomavirus (HPV) DNA could be present on objects that are used for the management of patients with genital HPV infections. Human papillomavirus DNA was identified by filter hybridization in swabs taken from eight of 16 (50%) of surgical gloves. Similarly, HPV DNA was found in 23 of 62 (37%) and one of 62 (1.6%) of biopsy forceps before and after sterilization in 30% tincture of Savlon for 30 min, respectively. Five of 22 (23%) and one of 22 (4.5%) of cryoprobe tips tested positive for HPV DNA before and after cleaning with 90% ethanol solution for 1 min, respectively. The rate of HPV DNA positivity after sterilization is low. Whether HPV on fomites is infectious was not evaluated in this study. Washing and soaking them in detergents containing 2010glutaraldehyde or heating them to 1OOCor higher should be adequate. Use of separate gloves for manual examination of the external and internal anogenital tract is advisable.
Int J Gynecol Obstet 32
Goedert J.J.; Drummond J.E.; Minkoff H.L.; Stevens R.; Blattner W.A.; Mendez H.; Robert-Guroff M.; Holman S.; Rubinstein A.; Willoughby A.; Landesman S.H. Viral Epidemiology Section, National Cancer Institute, 434 Executive Plaza North, Bethesda, MD 20892, USA LANCET 1989,2/8676(1X1-1354) In a prospective study of pregnant women infected with human immunodeficiency virus type 1 (HIV-l) in Brooklyn, New York, USA, 16 (29%) of 55 evaluable infants were infected with HIV-l. 9 infants had paediatric acquired immunodeficiency syndrome, 6 had less severe clinical manifestations of HIV-l infection, and 1 was symptom-free but was seropositive for HIV-l beyond 15 months of age. The 10 infants born at 37 weeks of gestation or earlier were at higher risk of HIV-l infection than infants born at 38 weeks of gestation or later (60@/0 vs 22%) but the median age at appearance of disease was approximately 5 months in the both groups. The HIV-l transmission rate was not associated with predelivery levels of maternal T cells, anti-p24, or neutralising antibodies but it was higher, among full-term infants, for those with mothers in the lowest third of the distribution of anti-gp120 levels (53%). On immunoblot, transmitting mothers lacked a gp120 band but not other bands. Protection was not associated with antibody to recombinant peptides from the hypervariable region of the major neutralising gpl20 epitope, and the antigpl20 endpoint dilution titre was similar in transmitting and non-transmitting mothers. Mothers of uninfected full-term infants appear to confer immunological protection against HIV-l infection of their offspring by way of a high-affinity antibody to a gpl20 epitope, whose specificity has importance possibly perinatal for vaccine development and immunotherapy.
Fetal death from chlamydiai infection across intact amniotic membranes
Thorp J.M. Jr.; Katz V.L.; Fowler L.J.; Kurtzman J.T.; Bowes W.A. Jr. Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hilt, NC 275997570, USA AM. J. OBSTET. GYNECOL., 1989, 161/5 (1245-1246) We report a case of a fetal death at 34 weeks’ gestation with intact membranes. An autopsy confirmed intrauterine pneumonia as a result of Chlamydia trachomatis. Staining of the lung tissue with a direct fluorescein-conjugated Chlamydiaspecific monoclonal antibody assay revealed a pattern typical of a Chlamydia trachomatis infection. This case supports the thesis that Chlamydia crosses fetal membranes and produces disease.
291
The effect of bacteriostatic lubricant on group B streptococcal cultures of the female genitai tract Brady K.;Sizem0reK.L.; Duff P.; Aamodt L.W.
Division of Maternal Fetal Medicine, Madigan Army Medical Center, Tacoma, WA 98431-5418, USA OBSTET. GYNECOL. 1989,74/6 (848-850) The purpose of this prospective investigation was to determine the effect of bacteriostatic lubricant on group B streptococcal cultures obtained from the lower genital tract of pregnant women. Fifty pregnant women with intact membranes who recently had genital tract cultures for group B streptococci were evaluated. The study group consisted of 25 women who had positive cultures, and the control group comprised 25 women who had negative cultures. All patients underwent examination with a sterile nonlubricated speculum within 7 days of the previously obtained cultures. Secretions from the endocervix and from the posterior vaginal wall near the introitus were collected with a sterile cotton-tipped applicator and inoculated directly onto a selective blood agar culture plate. The sterile speculum was removed and a digital examination performed using bacteriostatic lubricant. A second sterile speculum was then inserted into the vagina and another group B streptococcal culture was obtained. There was 100% correlation between the cultures obtained before and after the vaginal examination. We conclude that use of bacteriostatic lubricant does not alter the recovery of group B streptococci from the genital tract of pregnant women with intact membranes.
Human papiilomaviros DNA in fomites on objects used for the management of patients with genital human papillomavirus infections Ferenczy A.;Bergeron C.; Richart R.M.
Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, Que. H3TIE2, CAN OBSTET. GYNECOL. 1989,74/6 (950-954) We investigated the possibility that human papillomavirus (HPV) DNA could be present on objects that are used for the management of patients with genital HPV infections. Human papillomavirus DNA was identified by filter hybridization in swabs taken from eight of 16 (50%) of surgical gloves. Similarly, HPV DNA was found in 23 of 62 (37%) and one of 62 (1.6%) of biopsy forceps before and after sterilization in 30% tincture of Savlon for 30 min, respectively. Five of 22 (23%) and one of 22 (4.5%) of cryoprobe tips tested positive for HPV DNA before and after cleaning with 90% ethanol solution for 1 min, respectively. The rate of HPV DNA positivity after sterilization is low. Whether HPV on fomites is infectious was not evaluated in this study. Washing and soaking them in detergents containing 2010glutaraldehyde or heating them to 1OOCor higher should be adequate. Use of separate gloves for manual examination of the external and internal anogenital tract is advisable.
Int J Gynecol Obstet 32