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Sexually Transmitted Diseases HELP
Based on 99,945 articles published since 2010
|||| 17 

These are the 99945 published articles about Sexually Transmitted Diseases that originated from Worldwide during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Update to U.S. Medical Eligibility Criteria for Contraceptive Use, 2016: Updated Recommendations for the Use of Contraception Among Women at High Risk for HIV Infection. 2020

Tepper, Naomi K / Curtis, Kathryn M / Cox, Shanna / Whiteman, Maura K. ·Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. ·MMWR Morb Mortal Wkly Rep · Pubmed #32271729.

ABSTRACT: "U.S. Medical Eligibility Criteria for Contraceptive Use" (U.S. MEC) 2016 provides evidence-based guidance for the safe use of contraceptive methods among U.S. women with certain characteristics or medical conditions (1). The U.S. MEC is adapted from global guidance from the World Health Organization (WHO) and kept up to date through continual review of published literature (1). CDC recently evaluated the evidence and the updated WHO guidance on the risk for human immunodeficiency virus (HIV) acquisition among women using hormonal contraception and intrauterine devices (IUDs) (2). After careful review, CDC adopted WHO's 2019 updated guidance for inclusion in the U.S. MEC guidance; CDC's updated guidance states that progestin-only injectable contraception (including depot medroxyprogesterone acetate [DMPA]) and IUDs (including levonorgestrel-releasing and copper-bearing) are safe for use without restriction among women at high risk for HIV infection (U.S. MEC category 1 [previously U.S. MEC category 2, advantages outweigh risks]) (Box). CDC's guidance also adds an accompanying clarification for women who wish to use IUDs, which states "Many women at a high risk for HIV infection are also at risk for other sexually transmitted diseases (STDs). For these women, refer to the recommendations in the 'U.S. Medical Eligibility Criteria for Contraceptive Use' for women with other factors related to STDs, and the 'U.S. Selected Practice Recommendations for Contraceptive Use' on STD screening before IUD insertion" (1,3). Recommendations for other hormonal contraceptive methods (including combined hormonal methods, implants, and progestin-only pills) remain the same; there is also no restriction for their use among women at high risk for HIV infection (U.S. MEC category 1). Finally, CDC clarified that the U.S. MEC recommendations for concurrent use of hormonal contraceptives or IUDs and antiretroviral use for treatment of HIV infection also apply to use of antiretrovirals for prevention of HIV acquisition (preexposure prophylaxis [PrEP]).

2 Guideline Health Care Decision Making for Reproductive Care. 2020

Anonymous3231142. · ·Nurs Womens Health · Pubmed #32083556.

ABSTRACT: -- No abstract --

3 Guideline Sexually transmitted infections - laboratory diagnosis. 2019

Hachul, Maurício / Medeiros, Marcus Vinícius Verardo de / Simões, Ricardo / Bernardo, Wanderley Marques. ·Brazilian Society of Urology, São Paulo, SP, Brasil. · Brazilian Medical Association, São Paulo, SP, Brasil. ·Rev Assoc Med Bras (1992) · Pubmed #31340297.

ABSTRACT: The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

4 Guideline 2019 European guideline on the management of lymphogranuloma venereum. 2019

de Vries, H J C / de Barbeyrac, B / de Vrieze, N H N / Viset, J D / White, J A / Vall-Mayans, M / Unemo, M. ·STI Outpatient Clinic, Infectious Diseases Department, Public Health Service Amsterdam, Amsterdam, The Netherlands. · Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. · Mycoplasmal and Chlamydial Infections in Humans, University of Bordeaux, Bordeaux, France. · Mycoplasmal and Chlamydial Infections in Humans, INRA, Bordeaux, France. · Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bacteriologie, French National Reference Center for Bacterial STIs, Bordeaux, France. · Department of Dermatology, University Medical Centre Utrecht, Utrecht, The Netherlands. · Department of Genitourinary Medicine, Western Health & Social Care Trust, Londonderry, UK. · STI Unit Vall d'Hebron-Drassanes, Department of Infectious Diseases, Hospital Vall d'Hebron, Barcelona, Spain. · WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. ·J Eur Acad Dermatol Venereol · Pubmed #31243838.

ABSTRACT: New or important issues in this updated version of the 2013 European guideline on the management of lymphogranuloma venereum (LGV): EPIDEMIOLOGY: Lymphogranuloma venereum continues to be endemic among European men who have sex with men (MSM) since 2003. Lymphogranuloma venereum infections in heterosexuals are extremely rare in Europe, and there is no evidence of transmission of LGV in the European heterosexual population. AETIOLOGY AND TRANSMISSION: Chlamydia trachomatis serovars/genovars L2b and L2 are the causative strains in the majority of cases in Europe. CLINICAL FEATURES: Among MSM, about 25% of the anorectal LGV infections are asymptomatic. Genital infections among MSM are rare; the ratio of genital vs. anorectal LGV infections is 1 in 15. DIAGNOSIS: To diagnose LGV, a sample tested C. trachomatis positive with a commercial nucleic acid amplification test (NAAT) platform should be confirmed with an LGV discriminatory NAAT. TREATMENT: Doxycycline 100 mg twice a day orally for 21 days is the recommended treatment for LGV. This same treatment is recommended also in asymptomatic patients and contacts of LGV patients. If another regimen is used, a test of cure (TOC) must be performed.

5 Guideline Preexposure Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement. 2019

Anonymous1091153 / Owens, Douglas K / Davidson, Karina W / Krist, Alex H / Barry, Michael J / Cabana, Michael / Caughey, Aaron B / Curry, Susan J / Doubeni, Chyke A / Epling, John W / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Pbert, Lori / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Harvard Medical School, Boston, Massachusetts. · University of California, San Francisco. · Oregon Health & Science University, Portland. · University of Iowa, Iowa City. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · University of Massachusetts Medical School, Worcester. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #31184747.

ABSTRACT: Importance: An estimated 1.1 million individuals in the United States are currently living with HIV, and more than 700 000 persons have died of AIDS since the first cases were reported in 1981. In 2017, there were 38 281 new diagnoses of HIV infection reported in the United States; 81% of these new diagnoses were among males and 19% were among females. Although treatable, HIV infection has no cure and has significant health consequences. Objective: To issue a new US Preventive Services Task Force (USPSTF) recommendation on preexposure prophylaxis (PrEP) for the prevention of HIV infection. Evidence Review: The USPSTF reviewed the evidence on the benefits of PrEP for the prevention of HIV infection with oral tenofovir disoproxil fumarate monotherapy or combined tenofovir disoproxil fumarate and emtricitabine and whether the benefits vary by risk group, population subgroup, or regimen or dosing strategy; the diagnostic accuracy of risk assessment tools to identify persons at high risk of HIV acquisition; the rates of adherence to PrEP in primary care settings; the association between adherence and effectiveness of PrEP; and the harms of PrEP when used for HIV prevention. Findings: The USPSTF found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV acquisition. The USPSTF also found convincing evidence that adherence to PrEP is highly associated with its efficacy in preventing the acquisition of HIV infection; thus, adherence to PrEP is central to realizing its benefit. The USPSTF found adequate evidence that PrEP is associated with small harms, including kidney and gastrointestinal adverse effects. The USPSTF concludes with high certainty that the magnitude of benefit of PrEP with oral tenofovir disoproxil fumarate-based therapy to reduce the risk of acquisition of HIV infection in persons at high risk is substantial. Conclusions and Recommendation: The USPSTF recommends offering PrEP with effective antiretroviral therapy to persons at high risk of HIV acquisition. (A recommendation).

6 Guideline Screening for HIV Infection: US Preventive Services Task Force Recommendation Statement. 2019

Anonymous1081153 / Owens, Douglas K / Davidson, Karina W / Krist, Alex H / Barry, Michael J / Cabana, Michael / Caughey, Aaron B / Curry, Susan J / Doubeni, Chyke A / Epling, John W / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Pbert, Lori / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Harvard Medical School, Boston, Massachusetts. · University of California, San Francisco. · Oregon Health & Science University, Portland. · University of Iowa, Iowa City. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · University of Massachusetts Medical School, Worcester. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #31184701.

ABSTRACT: Importance: Approximately 1.1 million persons in the United States are currently living with HIV, and more than 700 000 persons have died of AIDS since the first cases were reported in 1981. There were approximately 38 300 new diagnoses of HIV infection in 2017. The estimated prevalence of HIV infection among persons 13 years and older in the United States is 0.4%, and data from the Centers for Disease Control and Prevention show a significant increase in HIV diagnoses starting at age 15 years. An estimated 8700 women living with HIV give birth each year in the United States. HIV can be transmitted from mother to child during pregnancy, labor, delivery, and breastfeeding. The incidence of perinatal HIV infection in the United States peaked in 1992 and has declined significantly following the implementation of routine prenatal HIV screening and the use of effective therapies and precautions to prevent mother-to-child transmission. Objective: To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on screening for HIV infection in adolescents, adults, and pregnant women. Evidence Review: The USPSTF reviewed the evidence on the benefits and harms of screening for HIV infection in nonpregnant adolescents and adults, the yield of screening for HIV infection at different intervals, the effects of initiating antiretroviral therapy (ART) at a higher vs lower CD4 cell count, and the longer-term harms associated with currently recommended ART regimens. The USPSTF also reviewed the evidence on the benefits (specifically, reduced risk of mother-to-child transmission of HIV infection) and harms of screening for HIV infection in pregnant persons, the yield of repeat screening for HIV at different intervals during pregnancy, the effectiveness of currently recommended ART regimens for reducing mother-to-child transmission of HIV infection, and the harms of ART during pregnancy to the mother and infant. Findings: The USPSTF found convincing evidence that currently recommended HIV tests are highly accurate in diagnosing HIV infection. The USPSTF found convincing evidence that identification and early treatment of HIV infection is of substantial benefit in reducing the risk of AIDS-related events or death. The USPSTF found convincing evidence that the use of ART is of substantial benefit in decreasing the risk of HIV transmission to uninfected sex partners. The USPSTF also found convincing evidence that identification and treatment of pregnant women living with HIV infection is of substantial benefit in reducing the rate of mother-to-child transmission. The USPSTF found adequate evidence that ART is associated with some harms, including neuropsychiatric, renal, and hepatic harms, and an increased risk of preterm birth in pregnant women. The USPSTF concludes with high certainty that the net benefit of screening for HIV infection in adolescents, adults, and pregnant women is substantial. Conclusions and Recommendation: The USPSTF recommends screening for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened. (A recommendation) The USPSTF recommends screening for HIV infection in all pregnant persons, including those who present in labor or at delivery whose HIV status is unknown. (A recommendation).

7 Guideline 2018 European guideline on the organization of a consultation for sexually transmitted infections. 2019

Gamoudi, D / Flew, S / Cusini, M / Benardon, S / Poder, A / Radcliffe, K. ·Nottingham University Hospitals NHS Trust, Nottingham, UK. · U.O. Dermatologia e Venereologia, IRCCS Fondazione Ca' Granda, Policlinico di Milano, Milano, Italy. · Clinical Research Centre, Tartu University Clinics, Tartu, Estonia. · University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. ·J Eur Acad Dermatol Venereol · Pubmed #30968975.

ABSTRACT: -- No abstract --

8 Guideline [Treatment of uncomplicated pelvic inflammatory disease: CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines]. 2019

Verdon, R. ·Service de maladies infectieuses et tropicales, CHRU de Caen, 14000 Caen, France; Groupe de recherche sur l'adaptation microbienne (GRAM 2.0), Normandie university, UNICAEN, 14000 Caen, France. Electronic address: verdon-r@chu-caen.fr. ·Gynecol Obstet Fertil Senol · Pubmed #30878689.

ABSTRACT: This review of the treatment of uncomplicated pelvic inflammatory disease (PID) focuses on the susceptibility profile of the main microbiological causes as well as on the advantages and inconvenients of relevant antibiotics. As bacterial resistance is expanding in the community, the rules of adequate antibiotic prescribing are integrated in the treatment proposals. While the pathogenic role of anaerobic bacteria in uncomplicated PID remains discussed, the choice to provide anaerobes coverage is proposed. Thus, the antibiotic treatment has to cover Chamydia trachomatis, Neisseria gonorrhoeae, anaerobes as well as Streptococcus spp, gram negative bacteria and the ermerging Mycoplasma genitalium. On the basis of published trials and good practice antibiotic usage, the ceftriaxone-doxycycline-metronidazole combination has been selected as the first line regimen. Fluoroquinolones (moxifloxacin alone, or levofloxacin or ofloxacin combined with metronidazole) are proposed as alternatives because of their ecological impact and their side effects leading to restricted usage. When fluoroquinolone are used, ceftriaxone should be added in case of possible sexually transmitted infection. When detected, M. genitalium should be treated by moxifloxacin. Moreover, this review highlights the need to better describe the microbiological epidemiology of uncomplicated PID in France or Europe.

9 Guideline [Pelvic inflammatory diseases: Microbiologic diagnosis - CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines]. 2019

Cazanave, C / de Barbeyrac, B. ·Service des maladies infectieuses et tropicales, groupe hospitalier Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France; Infections humaines à mycoplasmes et chlamydiae, USC EA 3671, Institut national de la recherche agronomique, université Bordeaux, 33000 Bordeaux, France; Centre national de référence des infections sexuellement transmissibles bactériennes, CHU de Bordeaux, 33000 Bordeaux, France. Electronic address: charles.cazanave@chu-bordeaux.fr. · Infections humaines à mycoplasmes et chlamydiae, USC EA 3671, Institut national de la recherche agronomique, université Bordeaux, 33000 Bordeaux, France; Centre national de référence des infections sexuellement transmissibles bactériennes, CHU de Bordeaux, 33000 Bordeaux, France; Laboratoire de bactériologie, groupe hospitalier Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France. ·Gynecol Obstet Fertil Senol · Pubmed #30878688.

ABSTRACT: OBJECTIVES: To determine the microorganisms potentially involved in pelvic inflammatory diseases (PIDs) and the different diagnostic methods of PID. METHODS: PubMed and International Guidelines search. RESULTS: PIDs have various microbial causes. The pathogenic role of the main agents of sexually transmitted infections (STIs), Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium is well demonstrated (NP1). C. trachomatis is the most commonly described bacterium in PID (NP1), especially in women under 30 years old. PIDs also occur in situations that decrease the effectiveness of the cervix microbiological lock, such as bacterial vaginosis, allowing facultative vaginal bacteria such as Escherichia coli, Streptococcus agalactiae and anaerobes to ascend to the uterine cavity. Nevertheless, participation of the diverse bacteria of the vaginal microbiota, in particular anaerobes, and the polymicrobial character of PIDs are still differently appreciated. In the case of uncomplicated PID, to obtain a microbiological diagnosis, endocervical sampling is recommended during gynecological examination under speculum (grade B). A first swab allows for a smear on a slide for direct examination (Gram, MGG). A second swab, in an adapted transport medium, is useful for standard culture with N. gonorrhoeae and facultative vaginal flora bacteria cultures, with antibiotic susceptibility testing. A third swab, in an appropriate transport medium, allows for the search for N. gonorrhoeae, C. trachomatis, and if possible M. genitalium by nucleic acid amplification techniques (NAATs), (NP1). It is possible to only use one swab in a transport medium suitable for (i) survival of bacteria and (ii) NAATs. When the diagnosis of PID is clinically compatible, a positive NAAT for one or more of the three STI-associated bacteria on a genital sample supports the PID diagnosis (NP1). On the other hand, a negative NAAT does not allow the exclusion of an STI agent for PID diagnosis (NP1). In situations where speculum use is not possible, vaginal sampling will be performed by default. In case of complicated IGH, tuboperitoneal samples can be performed either radiologically or surgically. Since these sites are sterile, any bacteria present will be considered pathogenic (NP2). C. trachomatis serology is not interesting as a first line diagnostic tool for PID diagnosis and is not useful for monitoring the evolution of PID (NP1).

10 Guideline [Follow-up and counselling after pelvic inflammatory disease: CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines]. 2019

Ah-Kit, X / Hoarau, L / Graesslin, O / Brun, J-L. ·Pôle d'obstétrique - reproduction - gynécologie, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. · Service de gynécologie-obstétrique, institut Mère-Enfant Alix-de-Champagne, 45, rue Cognacq-Jay, 51092 Reims cedex, France. · Pôle d'obstétrique - reproduction - gynécologie, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; UMR 5234, microbiologie fondamentale & pathogénicité, université de Bordeaux, 33076 Bordeaux, France. Electronic address: jean-luc.brun@chu-bordeaux.fr. ·Gynecol Obstet Fertil Senol · Pubmed #30878686.

ABSTRACT: OBJECTIVES: To determine the procedures for follow-up and counselling of patients after pelvic inflammatory disease (PID). METHODS: A search in the Cochrane database, PubMed, and Google was performed using keywords related to follow-up and PID to identify reports published between 1990 and 2018. All studies published in French and English relevant to the areas of focus were included. A level of evidence (LE) based on the quality of the data available was applied for each area of focus and used for the guidelines. RESULTS: The rate of recurrent PID is 15 to 21%. They are related to a recurrent sexually transmitted infection (STI) in 20 to 34% of cases. Recurrence PID increase the risk of infertility and chronic pelvic pain (LE2). Follow-up is recommended after PID (grade C). The rate of patients lost to follow-up is around 40%. Follow-up is improved by personalized text message reminders (grade B). Vaginal sampling for detection of N. gonorrhoeae, C. trachomatis, (and M. genitalium) by nucleic acid amplification techniques is recommended 3 to 6 months after treatment of PID associated with STI to rule out possible reinfections (grade C). The use of condoms after PID associated with STI is recommended to reduce the risk of recurrences (grade C). The systematic use of contraceptive pills after PID is not recommended to prevent subsequent infertility and chronic pelvic pain. Vaginal sampling for microbiological diagnosis is recommended before the insertion of an intrauterine device (grade B). The risk of ectopic pregnancy is high in these women and must be kept in mind. CONCLUSION: Patient counselling and microbiological testing after PID decrease the risk of STI and thus the recurrence of PID.

11 Guideline Diagnosis, prevention, and treatment of bone fragility in people living with HIV: a position statement from the Swiss Association against Osteoporosis. 2019

Biver, E / Calmy, A / Aubry-Rozier, B / Birkhäuser, M / Bischoff-Ferrari, H A / Ferrari, S / Frey, D / Kressig, R W / Lamy, O / Lippuner, K / Suhm, N / Meier, C. ·Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. · HIV/Aids Unit, Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. · Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland. · Gynecological Endocrinology and Reproductive Medicine, University of Berne, Basel, Switzerland. · Department of Geriatrics and Aging Research, University of Zurich and University Hospital of Zurich, Zurich, Switzerland. · Division of Rheumatology, University Hospital Zürich, Zürich, Switzerland. · University Center for Medicine of Aging, Basel Mobility Center, University of Basel, Basel, Switzerland. · Department of Osteoporosis, University Hospital, University of Berne, Berne, Switzerland. · Department of Orthopedics and Traumatology, Geriatric Fracture Center, University Hospital Basel, Basel, Switzerland. · Division of Endocrinology, Diabetology & Metabolism, University Hospital and University of Basel, Missionsstrasse 24, CH-4055, Basel, Switzerland. christian.meier@unibas.ch. ·Osteoporos Int · Pubmed #30603840.

ABSTRACT: Life expectancy of people living with HIV (PLWH) is reaching similar length as in the general population. Accordingly, age-related comorbidities, including osteoporosis, are increasing. Fracture risk is higher and increases approximately 10 years earlier in PLWH. Classical risk factors of bone fragility are highly prevalent in PLWH but factors specific for HIV infection itself and the type of antiretroviral therapy (ART) (triple combination antiretroviral therapy) regimen (especially tenofovir and protease inhibitors) also contribute to bone loss. The majority of bone loss occurs during virus activity and at initiation of ART (immune reconstitution) and is associated with an increase of bone resorption (upregulation RANKL). Recent data indicate that calcium and vitamin D supplements as ART initiation lower BMD loss. The reduction of tenofovir plasma concentrations with tenofovir alafenamide attenuates BMD loss but it remains unknown whether it will contribute to reduce fracture risk. Hence, special considerations for the management of bone fragility in PLWH are warranted. Based on the current state of epidemiology and pathophysiology of osteoporosis in PLWH, we provide the consensus of the Swiss Association against Osteoporosis on best practice for diagnosis, prevention, and management of osteoporosis in this population. Periodic assessment of fracture risk is indicated in all HIV patients and general preventive measures should be implemented. All postmenopausal women, men above 50 years of age, and patients with other clinical risk for fragility fractures qualify for BMD measurement. An algorithm clarifies when treatment with bisphosphonates and review of ART regimen in favour of more bone-friendly options are indicated.

12 Guideline The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis-Executive summary. 2019

Holroyd, Christopher R / Seth, Rakhi / Bukhari, Marwan / Malaviya, Anshuman / Holmes, Claire / Curtis, Elizabeth / Chan, Christopher / Yusuf, Mohammed A / Litwic, Anna / Smolen, Susan / Topliffe, Joanne / Bennett, Sarah / Humphreys, Jennifer / Green, Muriel / Ledingham, Jo. ·Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK. · Rheumatology Department, University Hospitals of Morecombe Bay NHS Foundation Trust, Lancaster, UK. · Rheumatology Department, Mid Essex Hospital NHS Trust, Chelmsford, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · Rheumatology Department, Salisbury District Hospital, Salisbury, UK. · Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK. · National Rheumatoid Arthritis Society, Queen Alexandra Hospital, Portsmouth, UK. · Rheumatology Department, Queen Alexandra Hospital, Portsmouth, UK. ·Rheumatology (Oxford) · Pubmed #30137623.

ABSTRACT: -- No abstract --

13 Guideline The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis. 2019

Holroyd, Christopher R / Seth, Rakhi / Bukhari, Marwan / Malaviya, Anshuman / Holmes, Claire / Curtis, Elizabeth / Chan, Christopher / Yusuf, Mohammed A / Litwic, Anna / Smolen, Susan / Topliffe, Joanne / Bennett, Sarah / Humphreys, Jennifer / Green, Muriel / Ledingham, Jo. ·Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK. · Rheumatology Department, University Hospitals of Morecombe Bay NHS Foundation Trust, Lancaster, UK. · Rheumatology Department, Mid Essex hospitals NHS Trust, Chelmsford, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · Rheumatology Department, Salisbury District Hospital, Salisbury, UK. · Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK. · National Rheumatoid Arthritis Society, Queen Alexandra Hospital, Portsmouth, UK. · Rheumatology Department, Queen Alexandra Hospital, Portsmouth, UK. ·Rheumatology (Oxford) · Pubmed #30137552.

ABSTRACT: -- No abstract --

14 Guideline 2018 Belgian guidelines for the screening for latent tuberculosis in HIV-infected patients. 2019

Wyndham-Thomas, Chloé / Dirix, Violette / Goffard, Jean-Christophe / Henrard, Sophie / Wanlin, Maryse / Callens, Steven / Mascart, Françoise / Van Vooren, Jean-Paul. ·a Immunodeficiency Treatment Unit, Hôpital Erasme , Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium. · b Laboratory of Vaccinology and Mucosal Immunity , Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium. · c Fonds des Affections Respiratoires(FARES) , Belgium. · d Belgian Lung and Tuberculosis Association (BELTA) , Belgium. · e Dept of General Internal Medicine , University Hospital Ghent , Ghent , Belgium. · f Immunobiology Unit, Hôpital Erasme , Université Libre de Bruxelles (U.L.B) , Brussels , Belgium. ·Acta Clin Belg · Pubmed #30036162.

ABSTRACT:

15 Guideline Executive summary of the GeSIDA/National AIDS Plan consensus document on antiretroviral therapy in adults infected by the human immunodeficiency virus (updated January 2018). 2019

Anonymous6500946. · ·Enferm Infecc Microbiol Clin · Pubmed #29759422.

ABSTRACT: This update to the document on antiretroviral therapy (ART) in adults, which has been prepared jointly by GeSIDA and the Spanish National AIDS Plan for the last two decades, supersedes the document published in 2017.

16 Guideline Executive summary of the consensus document on metabolic disorders and cardiovascular risk in patients with HIV infection. 2019

Anonymous4060916 / Anonymous4070916 / Anonymous4080916. ·Secretaría del Plan Nacional sobre el Sida, Ministerio de Sanidad, Servicios Sociales e Igualdad, Madrid, España. ·Enferm Infecc Microbiol Clin · Pubmed #28823613.

ABSTRACT: Patients with HIV infection have a higher cardiovascular risk than the general population. The identification of patients with high CVR, the implementation of preventive measures and the control of modifiable risk factors, especially in patients on antiretroviral therapy should be part of the management of HIV infection. This document updates the recommendations published in 2014, mainly regarding lipid, glucose, arterial hypertension alterations and cardiovascular risk (CVR). The objective of metabolic monitoring is A1C ≤7%, similar to that of non-infected population, individualising by age, life expectancy, comorbidities, hypoglycaemia risk and costs. Cardiovascular risk should be calculated in all HIV patients with a risk calculator available for clinical use, even though we recommend the use of REGICOR tables as we are treating the Spanish population. Proper measurement of blood pressure should be a routine practice in the care of patients with HIV infection. The aim of this document is to provide tools for the diagnosis and appropriate treatment of the main metabolic alterations to serve as a reference to professionals who care for people with HIV infection.

17 Guideline [Intrauterine contraception: CNGOF Contraception Guidelines]. 2018

Vidal, F / Paret, L / Linet, T / Tanguy le Gac, Y / Guerby, P. ·Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France. Electronic address: vidal.fabien@chu-toulouse.fr. · Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Université Toulouse III, 118, route de Narbonne, 31062 Toulouse, France. · Service de gynécologie-obstétrique, centre hospitalier Loire-Vendée-Océan, 85300 Challans, France. · Pôle Femme Mère Couple, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse, France. ·Gynecol Obstet Fertil Senol · Pubmed #30429071.

ABSTRACT: OBJECTIVE: To provide national clinical guidelines focusing on intrauterine contraception. METHODS: A systematic review of available literature was performed using Pubmed and Cochrane libraries. American, British and Canadian guidelines were considered as well. RESULTS: Intrauterine contraception (IUC) displays a wide panel of indications, including adolescents, nulliparous, patients living with HIV before AIDS (Grade B) and women with history of ectopic pregnancy (Grade C). Cervical cancer screening should not be modified in women with IUC (Grade B). Bimanual examination and cervix inspection are mandatory before device insertion (Grade B). Patients should not systematically undergo screening for sexually transmitted infections (STI) before device insertion (Grade B). Screening for STI should be preferably done before insertion but it can be performed at the time of device insertion in asymptomatic women (Grade B). Routine antibiotic prophylaxis and premedication are not recommended before insertion (Grade A). A follow-up visit may be offered several weeks after insertion (Professional consensus). Routine pelvic ultrasound examination in not recommended after device insertion (Grade B). In patients with IUC, unscheduled bleeding, when persistent or associated with pelvic pain, requires further investigation to rule out complication (Professional agreement). Suspected uterine perforation warrants radiological workup to locate the device (Professional consensus). Laparoscopic approach should be preferred for elective removal of intrauterine device from abdominal cavity (Professional consensus). In case of accidental pregnancy with intrauterine device in situ, ectopic pregnancy should be excluded (Grade B). In case of viable and desired intrauterine pregnancy, intrauterine device removal is recommended if the strings are reachable (Grade C). Detection of Actinomyces-like organisms on pap smear in asymptomatic patients with intrauterine contraception does not require further intervention (Grade B). Immediate removal of intrauterine device is not recommended in case of STI or pelvic inflammatory disease (Grade B). Device removal should be considered in the absence of clinical improvement after 48 to 72 hours of appropriate treatment (Grade B). CONCLUSION: Intrauterine contraception is a long-acting and reversible contraception method displaying great efficacy and high continuation rate. In contrast, complication rate is low. It should thus be offered to both nulliparous and multiparous women.

18 Guideline [Contraception for adolescent : CNGOF Contraception guidelines]. 2018

Pienkowski, C / Cartault, A. ·Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Electronic address: pienkowski.c@chu-toulouse.fr. · Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. ·Gynecol Obstet Fertil Senol · Pubmed #30392989.

ABSTRACT: OBJECTIVE: The goal is to establish dialogue and determine the needs and skill levels of adolescence. This concerns sexuality, the prevention of STIs, the informed choice of contraception to avoid an unplanned pregnancy. MéTHODES: A systematic review based on literature about contraception AND teenagers was performed using Pubmed, Cochrane, national and international recommendations. RESULTS: The surveillance of the teenager contraception must integrate more specifically: global health with a stability of weight and corpulence, a sufficient calcium intake, the prevention of the sexually transmitted infections (STIs) and the vaccination against HPV. The 1st consultations with adolescent girls are an essential moment for dialogue in order to develop sexuality education. Main themes are: prevention of STIs with the use of condoms, detection of situations of precariousness or sexual abuse, and finally adherence to treatment to avoid unplanned pregnancy. Use of condoms associated with regular contraception is essential to assure a barrier against sexually transmitted infections (STIs) (NP1). To preserve the patient confidentiality, the patient is received alone (Grade B). She must be reassured about respect of anonymity and availability of free treatment. Clinical examination collects weight, height, BMI and blood pressure (Grade C). It is important to give them the choice of contraceptive method and provide objective information on the different contraceptive methods (NP2). If there are any contraindications, when the first prescription is a pill, it must be a 1st or 2nd generation pill with levonorgestrel. For some experts, it would be important to prescribe a pill at 30μg EE for better efficacy in case of forgetfulness in very young patients and for the good maintenance of bone mineralization (NP4). Information on long-acting reversible contraceptives, or LARCs, is essential. These contraceptive methods have proved their efficacy and their place in the first intention. (NP1). CONCLUSION: Prescribing contraception to a teenage girl requires the adaptation of the best treatment to her needs to prevent an unwanted pregnancy. This requires good information on prevention of STIs and on different methods of contraception in a confidence climate.

19 Guideline Guidelines on treatment of hepatitis C virus infection. Spanish Association for the Study of the Liver (AEEH). 2018

Calleja, Jose L / Macias, Juan / Forns, Xavier / Garcia, Federico / Berenguer, Marina / Garcia Deltoro, Miguel / Buti, Maria / Granados, Rafael / Carrion, Jose A / Morano, Luis / Fernandez, Inmaculada / Coste, Pablo / Pineda, Juan A. ·Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro, Instituto de Investigación Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, España. Electronic address: joseluis.calleja@uam.es. · Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, España; Grupo para el Estudio de las Hepatitis Víricas, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, España. · Servicio de Hepatología, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Universidad de Barcelona, Barcelona, España. · Grupo para el Estudio de las Hepatitis Víricas, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, España; Unidad de Gestión Clínica de Microbiología, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria (ibs), Red de Investigación en SIDA (Retic ISCiii RD16/0025), Granada, España. · Unidad de Hepatología, Hospital Universitari i Politécnic La Fe, IIS La Fe, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Universidad de Valencia, Valencia, España. · Grupo para el Estudio de las Hepatitis Víricas, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, España; Servicio de Enfermedades Infecciosas, Consorcio Hospital General Universitario de Valencia, Valencia, España. · Servicio de Hepatología, Hospital Universitario Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, España. · Grupo para el Estudio de las Hepatitis Víricas, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, España; Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, España. · Sección de Hepatología, Servicio de Digestivo, Hospital del Mar, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Universitat Autònoma de Barcelona, Barcelona, España. · Grupo para el Estudio de las Hepatitis Víricas, Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Madrid, España; Unidad de Patología Infecciosa, Hospital Universitario Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Universidad de Santiago de Compostela, Vigo, Pontevedra, España. · Unidad de Hepatología, Hospital Universitario 12 de Octubre, Madrid, España. · Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro, Instituto de Investigación Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, España. ·Gastroenterol Hepatol · Pubmed #30270150.

ABSTRACT: -- No abstract --

20 Guideline [Practice recommendations for the use and interpretation of interferon gamma release assays in the diagnosis of latent and active tuberculosis]. 2018

Bergot, E / Abiteboul, D / Andréjak, C / Antoun, F / Barras, E / Blanc, F-X / Bourgarit, A / Charlois-Ou, C / Delacourt, C / Dirou, S / Gerin, M / Guerin, S / Haustraete, É / Henry, B / Lucet, J-C / Maitre, T / Morin, J / Le Palud, P / Pommelet, V / Rivoisy, C / Robert, J / Veziris, N / Herrmann, J-L. ·Service de pneumologie, CHRU Côte de Nacre, 14033 Caen, France. · Groupe d'étude sur le risque d'exposition de soignants aux agents infectieux (GERES), UFR de Médecine-site Bichat, 75018 Paris, France. · Service de pneumologie et réanimation, CHU Amiens Picardie, université Picardie Jules Verne, EA 4294, 80054 Amiens cedex 1, France. · Département de Paris, centre de lutte anti tuberculeuse, direction de l'action sociale de l'enfance et de la santé, 75013 Paris, France. · Service de pneumologie, l'institut du thorax, CHU de Nantes, université de Nantes, 44093 Nantes cedex 1, France. · Service de médecine interne, hôpital Jean Verdier, AP-HP, HUPSSD, 93140 Bondy, France; Inserm UMR 1149 CRI, université Paris 13, SmBH, 93140 Bondy, France. · Hôpital Necker-Enfants Malades, AP-HP, 75015 Paris, France. · Inserm UMR 1149 CRI, université Paris 13, SmBH, 93140 Bondy, France. · Service de Pneumologie, centre hospitalier Robert Bisson, 14107 Lisieux, France. · Service des maladies infectieuses et tropicales, centre d'infectiologie Necker Pasteur, hôpital Necker Enfants Malades, AP-HP, 75015 Paris, France; Institut Imagine, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France. · Unité d'hygiène de et de lutte contre l'infection nosocomiale (UHLIN), GH Bichat-Claude Bernard, AP-HP , 75877 Paris, France. · Inserm, U1135, centre d'immunologie et des maladies infectieuses, Sorbonne universités, Sorbonne université, 75013 Paris, France. · Service de pédiatrie générale, hôpital Robert-Debré, AP-HP, 75019 Paris, France. · Service de médecine interne, hôpital Jean Verdier, AP-HP, HUPSSD, 93140 Bondy, France. · Inserm, U1135, centre d'immunologie et des maladies infectieuses, Sorbonne universités, Sorbonne université, 75013 Paris, France; Laboratoire de bactériologie-hygiène, hôpital Pitié-Salpêtrière, centre national de référence des mycobactéries et de la résistance des mycobactéries aux antituberculeux, AP-HP, 75013 Paris, France. · Inserm, U1135, centre d'immunologie et des maladies infectieuses, Sorbonne universités, Sorbonne université, 75013 Paris, France; Département de bactériologie, hôpitaux universitaires de l'Est Parisien, centre national de référence des mycobactéries, AP-HP, 75012, Paris, France. · Laboratoire de bactériologie-hygiène, GHU hôpitaux Ile de France-Ouest, hôpital Raymond Poincaré, AP-HP, 92380 Garches, France; UMR1173, Inserm, université de Versailles Saint Quentin, UFR des sciences de la santé, 78180 Montigny le Bretonneux, France. Electronic address: jean-louis.herrmann@aphp.fr. ·Rev Mal Respir · Pubmed #30224215.

ABSTRACT: -- No abstract --

21 Guideline [Interferon gamma release assay tests and HIV infection]. 2018

Gerin, M / Bourgarit, A. ·HUPSSD, service de médecine interne, hôpital Jean-Verdier, AP-HP, 93140 Bondy, France. · HUPSSD, service de médecine interne, hôpital Jean-Verdier, AP-HP, 93140 Bondy, France; Université Paris 13, SmBH, 93140 Bondy, France; Inserm URM1149 CRI, 75013 Paris, France. Electronic address: anne.bourgaritdurand@aphp.fr. ·Rev Mal Respir · Pubmed #30224209.

ABSTRACT: -- No abstract --

22 Guideline Screening for Syphilis Infection in Pregnant Women: US Preventive Services Task Force Reaffirmation Recommendation Statement. 2018

Anonymous830961 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Kemper, Alex R / Kubik, Martha / Kurth, Ann E / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · Yale University, New Haven, Connecticut. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #30193283.

ABSTRACT: Importance: Untreated syphilis infection in pregnant women can be transmitted to the fetus (congenital syphilis) at any time during pregnancy or at birth. Congenital syphilis is associated with stillbirth, neonatal death, and significant morbidity in infants (eg, bone deformities and neurologic impairment). After a steady decline from 2008 to 2012, cases of congenital syphilis markedly increased from 2012 to 2106, from 8.4 to 15.7 cases per 100 000 live births (an increase of 87%). At the same time, national rates of syphilis increased among women of reproductive age. Objective: To update the US Preventive Services Task Force (USPSTF) 2009 recommendation on screening for syphilis infection in pregnant women. Evidence Review: The USPSTF commissioned a reaffirmation evidence update to identify new and substantial evidence sufficient enough to change its prior recommendation. Given the established benefits and practice of screening for syphilis in pregnant women, the USPSTF targeted its evidence review on the direct benefits of screening on the prevention of congenital syphilis morbidity and mortality and the harms of screening for and treatment of syphilis infection in pregnant women. Findings: Using a reaffirmation process, the USPSTF found that accurate screening algorithms are available to identify syphilis infection. Effective treatment with antibiotics can prevent congenital syphilis and significantly decrease adverse pregnancy outcomes, with small associated harms, providing an overall substantial health benefit. Therefore, the USPSTF reaffirms its previous conclusion that there is convincing evidence that screening for syphilis infection in pregnant women provides substantial benefit. Conclusions and Recommendation: The USPSTF recommends early screening for syphilis infection in all pregnant women. (A recommendation).

23 Guideline ACOG Committee Opinion No. 751: Labor and Delivery Management of Women With Human Immunodeficiency Virus Infection. 2018

Anonymous2610959 / Anonymous2620959. · ·Obstet Gynecol · Pubmed #30134427.

ABSTRACT: This Committee Opinion is being revised to provide updated guidance on the management of pregnant women during pregnancy and delivery to prevent mother-to-child transmission of the human immunodeficiency virus (HIV). Prevention of transmission of HIV from the woman to her fetus or newborn is a major goal in the care of pregnant women infected with HIV. Continuing research into mother-to-child transmission of HIV has suggested that a substantial number of cases of perinatal HIV transmission occur as the result of fetal exposure to the virus during labor and delivery. The precise mechanisms are not known. Established and ongoing research has shown that treatment of HIV-infected pregnant women with combined antiretroviral therapy can achieve a 1-2% or lower risk of mother-to-child transmission if maternal viral loads of 1,000 copies/mL or less can be sustained, independent of the route of delivery or duration of ruptured membranes before delivery. Vaginal delivery is appropriate for HIV-infected pregnant women who have been maintained on combined antiretroviral therapy and who have viral loads of 1,000 copies/mL or less at or near delivery. The risk of mother-to-child transmission in HIV-infected women with high viral loads can be reduced by performing cesarean deliveries before the onset of labor and before rupture of membranes (termed scheduled cesarean delivery in this document), in conjunction with the use of peripartum maternal antiretroviral therapy. Discussion of the option of scheduled cesarean delivery and its advantages in the situation of suboptimal viral suppression should begin as early as possible in pregnancy with every pregnant woman with HIV infection to give her an adequate opportunity to ask questions and consider her decision-making concerning the delivery plan. The patient's decision regarding her route of delivery should be respected after maternal and neonatal risks have been discussed.

24 Guideline ACOG Committee Opinion No. 752 Summary: Prenatal and Perinatal Human Immunodeficiency Virus Testing. 2018

Anonymous2560959. · ·Obstet Gynecol · Pubmed #30134421.

ABSTRACT: Given the enormous advances in the prevention of perinatal transmission of human immunodeficiency virus (HIV), it is clear that early identification and treatment of all pregnant women with HIV is the best way to prevent neonatal infection and also improve women's health. Furthermore, new evidence suggests that early initiation of antiretroviral therapy in the course of infection is beneficial for individuals infected with HIV and reduces the rate of sexual transmission to partners who are not infected. Screening should be performed after women have been notified that HIV screening is recommended for all pregnant patients and that they will receive an HIV test as part of the routine panel of prenatal tests unless they decline (opt-out screening). Human immunodeficiency virus testing using the opt-out approach, which is currently permitted in every jurisdiction in the United States, should be a routine component of care for women during prepregnancy and as early in pregnancy as possible. Repeat HIV testing in the third trimester, preferably before 36 weeks of gestation, is recommended for pregnant women with initial negative HIV antibody tests who are known to be at high risk of acquiring HIV infection; who are receiving care in facilities that have an HIV incidence in pregnant women of at least 1 per 1,000 per year; who are incarcerated; who reside in jurisdictions with elevated HIV incidence; or who have signs and symptoms consistent with acute HIV infection (eg, fever, lymphadenopathy, skin rash, myalgias, arthralgias, headache, oral ulcers, leukopenia, thrombocytopenia, or transaminase elevation). Rapid screening during labor and delivery or during the immediate postpartum period using the opt-out approach should be done for women who were not tested earlier in pregnancy or whose HIV status is otherwise unknown. Results should be available 24 hours a day and within 1 hour. If a rapid HIV test result in labor is reactive, antiretroviral prophylaxis should be immediately initiated while waiting for supplemental test results. If the diagnosis of HIV infection is established, the woman should be linked into ongoing care with a specialist in HIV care for comanagement.

25 Guideline ACOG Committee Opinion No. 751 Summary: Labor and Delivery Management ofWomenWith Human Immunodeficiency Virus Infection. 2018

Anonymous2550959. · ·Obstet Gynecol · Pubmed #30134420.

ABSTRACT: This Committee Opinion is being revised to provide updated guidance on the management of pregnant women during pregnancy and delivery to prevent mother-to-child transmission of the human immunodeficiency virus (HIV). Prevention of transmission of HIV from the woman to her fetus or newborn is a major goal in the care of pregnant women infected with HIV. Continuing research into mother-to-child transmission of HIV has suggested that a substantial number of cases of perinatal HIV transmission occur as the result of fetal exposure to the virus during labor and delivery. The precise mechanisms are not known. Established and ongoing research has shown that treatment of HIV-infected pregnant women with combined antiretroviral therapy can achieve a 1-2% or lower risk of mother-to-child transmission if maternal viral loads of 1,000 copies/mL or less can be sustained, independent of the route of delivery or duration of ruptured membranes before delivery. Vaginal delivery is appropriate for HIV-infected pregnant women who have been maintained on combined antiretroviral therapy and who have viral loads of 1,000 copies/mL or less at or near delivery. The risk of mother-to-child transmission in HIV-infected women with high viral loads can be reduced by performing cesarean deliveries before the onset of labor and before rupture of membranes (termed scheduled cesarean delivery in this document), in conjunction with the use of peripartum maternal antiretroviral therapy. Discussion of the option of scheduled cesarean delivery and its advantages in the situation of suboptimal viral suppression should begin as early as possible in pregnancy with every pregnant woman with HIV infection to give her an adequate opportunity to ask questions and consider her decision-making concerning the delivery plan. The patient's decision regarding her route of delivery should be respected after maternal and neonatal risks have been discussed.

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