Search

Objective The aim of the study was to describe pregnancies in HIV-infected teenagers. Methods A review of the case notes of HIV-infected pregnant teenagers aged 13-19 years from 12 London hospitals was carried out for the period 2000-2007. Results There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started postconception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (<37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again. Conclusion Obstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed. [ABSTRACT FROM AUTHOR]

We describe the demographics and treatment outcomes of a HIV-infected cohort from Croydon University Hospital, London, UK. We showed that the Croydon Cohort had good viral load suppression (98.6% with viral load < 100 copies/ml and 99.0% with viral load < 200 copies/ml) despite being a potentially challenging cohort in a deprived area of London. The viral load outcomes are better than the Public Health England data from 2014 and the latest British HIV Association audit using data from 2009. [ABSTRACT FROM AUTHOR]

Analyzes the changes in blood lipids and blood pressure during adolescence in England. Determination of high density lipoprotein (HDL) cholesterol concentration; Interrelation between smoking and HDL concentration; Association between urate concentration and cardiovascular disease risk factors.

The lipid results of a cross-sectional study of cardiovascular disease risk factors in over 600 13-18 year olds drawn from general practices in contrasting areas are reported. Differences were noted between the 3 practices, including a significant variation in the blood group distribution. HDL cholesterol showed a marked variation between the 3 practices which was unlikely to be due solely to seasonal variation. Alcohol consumption though not an univariate correlate of HDL cholesterol was however a strong partial correlate, as were age, height, sexual maturation, adiposity and smoking. Using 6 factors in each sex, 13% of the interchild variance of HDL cholesterol in boys could be explained in a multiple linear regression analysis, and 8% in girls. Including the practice variation as a further independent variable increased the explanation in 18% in boys and 15% in girls. An intraclass correlation (sib-sib) of 0.36 was found for HDL cholesterol, suggesting a strong familial influence. The implications of these results are discussed, along with the difficulties of screening for hyperlipidaemia in this age group.