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National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ?
The aim was to summarize national prevention of mother-to-child transmission (PMTCT) guidelines across Europe and to identify differences between these. A survey was conducted using a structured questionnaire sent to experts in 25 European countries from January to March 2012, requesting a copy of t...
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| Published in: | European journal of public health 2013-12, Vol.23 (6), p.1053-1058 |
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| Main Authors: | , , , , , , |
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| cites | cdi_FETCH-LOGICAL-c426t-66013905688d883601cd811b77026308cae1b130808275543f66444cef54b23e3 |
| container_end_page | 1058 |
| container_issue | 6 |
| container_start_page | 1053 |
| container_title | European journal of public health |
| container_volume | 23 |
| creator | Aebi-Popp, Karoline Mulcahy, Fiona Rudin, Christoph Hoesli, Irene Gingelmaier, Andrea Lyons, Fiona Thorne, Claire |
| description | The aim was to summarize national prevention of mother-to-child transmission (PMTCT) guidelines across Europe and to identify differences between these.
A survey was conducted using a structured questionnaire sent to experts in 25 European countries from January to March 2012, requesting a copy of the national guidelines. Responses were received from 23 countries.
Twenty-two (96%) countries supported a policy to recommend antenatal HIV screening for all pregnant women (15: opt-out strategy; 8: opt-in strategy). For HIV-positive women in whom the only indication for antiretroviral therapy (ART) was PMTCT, the recommended gestational age for commencing ART varied from 12 to 28 weeks: initiation before 19 weeks gestation was recommended in guidelines from nine countries; in France, the UK and the Netherlands, there was a wide range, from 14 to 24 weeks, whereas the Swiss and Ukrainian guidelines recommended starting at 24-28 weeks and the German/Austrian and Lithuanian at 28 weeks. Six national guidelines recommended inclusion of Zidovudine in antenatal ART regimens, and seven (37%) allowed continuation of Efavirenz for women conceiving on this drug. According to nine guidelines, zidovudine should always be used intrapartum. Eighteen national guidelines stated that HIV-positive women on successful ART can have a vaginal delivery. Viral load thresholds for vaginal delivery were |
| doi_str_mv | 10.1093/eurpub/ckt028 |
| format | article |
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A survey was conducted using a structured questionnaire sent to experts in 25 European countries from January to March 2012, requesting a copy of the national guidelines. Responses were received from 23 countries.
Twenty-two (96%) countries supported a policy to recommend antenatal HIV screening for all pregnant women (15: opt-out strategy; 8: opt-in strategy). For HIV-positive women in whom the only indication for antiretroviral therapy (ART) was PMTCT, the recommended gestational age for commencing ART varied from 12 to 28 weeks: initiation before 19 weeks gestation was recommended in guidelines from nine countries; in France, the UK and the Netherlands, there was a wide range, from 14 to 24 weeks, whereas the Swiss and Ukrainian guidelines recommended starting at 24-28 weeks and the German/Austrian and Lithuanian at 28 weeks. Six national guidelines recommended inclusion of Zidovudine in antenatal ART regimens, and seven (37%) allowed continuation of Efavirenz for women conceiving on this drug. According to nine guidelines, zidovudine should always be used intrapartum. Eighteen national guidelines stated that HIV-positive women on successful ART can have a vaginal delivery. Viral load thresholds for vaginal delivery were <1000 copies/ml in 5 countries, <400 copies/ml in 3 and <50 copies/ml in 11 countries.
There are important differences across Europe in national PMTCT guidelines, with most variation seen where the evidence-base remains limited. Such differences should be considered when interpreting research and surveillance findings.</description><identifier>ISSN: 1101-1262</identifier><identifier>EISSN: 1464-360X</identifier><identifier>DOI: 10.1093/eurpub/ckt028</identifier><identifier>PMID: 23478206</identifier><identifier>CODEN: EJPHF6</identifier><language>eng</language><publisher>England: Oxford Publishing Limited (England)</publisher><subject><![CDATA[AIDS Serodiagnosis - standards ; Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - therapeutic use ; Benzoxazines - administration & dosage ; Benzoxazines - therapeutic use ; Childbirth & labor ; Comparative studies ; Cross cultural studies ; Data Collection ; Delivery, Obstetric - standards ; Disease transmission ; Drugs ; Europe ; Female ; France ; Health care policy ; Health policy ; HIV ; HIV Infections - prevention & control ; HIV Infections - transmission ; Human immunodeficiency virus ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical - prevention & control ; Maternal & child health ; Medical service ; Netherlands ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious - drug therapy ; Prenatal Care - methods ; Prenatal Care - standards ; Public health ; Questionnaires ; Surveillance ; Surveys ; Surveys and Questionnaires ; Ukrainians ; United Kingdom ; Vagina ; Women ; Zidovudine - administration & dosage ; Zidovudine - therapeutic use]]></subject><ispartof>European journal of public health, 2013-12, Vol.23 (6), p.1053-1058</ispartof><rights>Copyright Oxford Publishing Limited(England) Dec 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-66013905688d883601cd811b77026308cae1b130808275543f66444cef54b23e3</citedby><cites>FETCH-LOGICAL-c426t-66013905688d883601cd811b77026308cae1b130808275543f66444cef54b23e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27864,27865,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23478206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aebi-Popp, Karoline</creatorcontrib><creatorcontrib>Mulcahy, Fiona</creatorcontrib><creatorcontrib>Rudin, Christoph</creatorcontrib><creatorcontrib>Hoesli, Irene</creatorcontrib><creatorcontrib>Gingelmaier, Andrea</creatorcontrib><creatorcontrib>Lyons, Fiona</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><title>National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ?</title><title>European journal of public health</title><addtitle>Eur J Public Health</addtitle><description>The aim was to summarize national prevention of mother-to-child transmission (PMTCT) guidelines across Europe and to identify differences between these.
A survey was conducted using a structured questionnaire sent to experts in 25 European countries from January to March 2012, requesting a copy of the national guidelines. Responses were received from 23 countries.
Twenty-two (96%) countries supported a policy to recommend antenatal HIV screening for all pregnant women (15: opt-out strategy; 8: opt-in strategy). For HIV-positive women in whom the only indication for antiretroviral therapy (ART) was PMTCT, the recommended gestational age for commencing ART varied from 12 to 28 weeks: initiation before 19 weeks gestation was recommended in guidelines from nine countries; in France, the UK and the Netherlands, there was a wide range, from 14 to 24 weeks, whereas the Swiss and Ukrainian guidelines recommended starting at 24-28 weeks and the German/Austrian and Lithuanian at 28 weeks. Six national guidelines recommended inclusion of Zidovudine in antenatal ART regimens, and seven (37%) allowed continuation of Efavirenz for women conceiving on this drug. According to nine guidelines, zidovudine should always be used intrapartum. Eighteen national guidelines stated that HIV-positive women on successful ART can have a vaginal delivery. Viral load thresholds for vaginal delivery were <1000 copies/ml in 5 countries, <400 copies/ml in 3 and <50 copies/ml in 11 countries.
There are important differences across Europe in national PMTCT guidelines, with most variation seen where the evidence-base remains limited. Such differences should be considered when interpreting research and surveillance findings.</description><subject>AIDS Serodiagnosis - standards</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Benzoxazines - administration & dosage</subject><subject>Benzoxazines - therapeutic use</subject><subject>Childbirth & labor</subject><subject>Comparative studies</subject><subject>Cross cultural studies</subject><subject>Data Collection</subject><subject>Delivery, Obstetric - standards</subject><subject>Disease transmission</subject><subject>Drugs</subject><subject>Europe</subject><subject>Female</subject><subject>France</subject><subject>Health care policy</subject><subject>Health policy</subject><subject>HIV</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - transmission</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Maternal & child health</subject><subject>Medical service</subject><subject>Netherlands</subject><subject>Practice Guidelines as Topic</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - drug therapy</subject><subject>Prenatal Care - methods</subject><subject>Prenatal Care - standards</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Surveillance</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Ukrainians</subject><subject>United Kingdom</subject><subject>Vagina</subject><subject>Women</subject><subject>Zidovudine - administration & dosage</subject><subject>Zidovudine - therapeutic use</subject><issn>1101-1262</issn><issn>1464-360X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>7TQ</sourceid><recordid>eNqNkUFP3DAQhS3UqtBtj1yRpV56MczYjuOcEEIUkFB7Kai3KHEm2tBsHOwY1H9fwy499NKe_OT59PRmHmOHCMcIlTqhFObUnrifC0i7xw5QGy2UgR9vskZAgdLIffY-xnsAKEor37F9qXQWYA7Y49dmGfzUjPwyDR2Nw0SR9z7wZU18DvRI0_Oc-55vfP4LYvHCrYex40toprgZYtzNr67veOOCj5FfpOBn4oKv_RPvPHc-TUsYsnU39D2F0w_sbd-MkT7u3hW7_XLx_fxK3Hy7vD4_uxFOS7MIYwBVBYWxtrM2b4Wus4htWYI0CqxrCFvMAqwsi0Kr3hittaO-0K1UpFbs89Z3Dv4hUVzqHNjRODYT-RRrLEBrLHUF_0Z1JQ1WYPR_oEairSCHX7FPf6H3PoV87xeqkDltWWZKbKmX8wXq6zkMmyb8qhHq55rrbc31tubMH-1cU7uh7g_92qv6DWRaor4</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Aebi-Popp, Karoline</creator><creator>Mulcahy, Fiona</creator><creator>Rudin, Christoph</creator><creator>Hoesli, Irene</creator><creator>Gingelmaier, Andrea</creator><creator>Lyons, Fiona</creator><creator>Thorne, Claire</creator><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>201312</creationdate><title>National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ?</title><author>Aebi-Popp, Karoline ; Mulcahy, Fiona ; Rudin, Christoph ; Hoesli, Irene ; Gingelmaier, Andrea ; Lyons, Fiona ; Thorne, Claire</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-66013905688d883601cd811b77026308cae1b130808275543f66444cef54b23e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>AIDS Serodiagnosis - standards</topic><topic>Anti-HIV Agents - administration & dosage</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Benzoxazines - administration & dosage</topic><topic>Benzoxazines - therapeutic use</topic><topic>Childbirth & labor</topic><topic>Comparative studies</topic><topic>Cross cultural studies</topic><topic>Data Collection</topic><topic>Delivery, Obstetric - standards</topic><topic>Disease transmission</topic><topic>Drugs</topic><topic>Europe</topic><topic>Female</topic><topic>France</topic><topic>Health care policy</topic><topic>Health policy</topic><topic>HIV</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - transmission</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Maternal & child health</topic><topic>Medical service</topic><topic>Netherlands</topic><topic>Practice Guidelines as Topic</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - drug therapy</topic><topic>Prenatal Care - methods</topic><topic>Prenatal Care - standards</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Surveillance</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Ukrainians</topic><topic>United Kingdom</topic><topic>Vagina</topic><topic>Women</topic><topic>Zidovudine - administration & dosage</topic><topic>Zidovudine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aebi-Popp, Karoline</creatorcontrib><creatorcontrib>Mulcahy, Fiona</creatorcontrib><creatorcontrib>Rudin, Christoph</creatorcontrib><creatorcontrib>Hoesli, Irene</creatorcontrib><creatorcontrib>Gingelmaier, Andrea</creatorcontrib><creatorcontrib>Lyons, Fiona</creatorcontrib><creatorcontrib>Thorne, Claire</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>European journal of public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aebi-Popp, Karoline</au><au>Mulcahy, Fiona</au><au>Rudin, Christoph</au><au>Hoesli, Irene</au><au>Gingelmaier, Andrea</au><au>Lyons, Fiona</au><au>Thorne, Claire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ?</atitle><jtitle>European journal of public health</jtitle><addtitle>Eur J Public Health</addtitle><date>2013-12</date><risdate>2013</risdate><volume>23</volume><issue>6</issue><spage>1053</spage><epage>1058</epage><pages>1053-1058</pages><issn>1101-1262</issn><eissn>1464-360X</eissn><coden>EJPHF6</coden><abstract>The aim was to summarize national prevention of mother-to-child transmission (PMTCT) guidelines across Europe and to identify differences between these.
A survey was conducted using a structured questionnaire sent to experts in 25 European countries from January to March 2012, requesting a copy of the national guidelines. Responses were received from 23 countries.
Twenty-two (96%) countries supported a policy to recommend antenatal HIV screening for all pregnant women (15: opt-out strategy; 8: opt-in strategy). For HIV-positive women in whom the only indication for antiretroviral therapy (ART) was PMTCT, the recommended gestational age for commencing ART varied from 12 to 28 weeks: initiation before 19 weeks gestation was recommended in guidelines from nine countries; in France, the UK and the Netherlands, there was a wide range, from 14 to 24 weeks, whereas the Swiss and Ukrainian guidelines recommended starting at 24-28 weeks and the German/Austrian and Lithuanian at 28 weeks. Six national guidelines recommended inclusion of Zidovudine in antenatal ART regimens, and seven (37%) allowed continuation of Efavirenz for women conceiving on this drug. According to nine guidelines, zidovudine should always be used intrapartum. Eighteen national guidelines stated that HIV-positive women on successful ART can have a vaginal delivery. Viral load thresholds for vaginal delivery were <1000 copies/ml in 5 countries, <400 copies/ml in 3 and <50 copies/ml in 11 countries.
There are important differences across Europe in national PMTCT guidelines, with most variation seen where the evidence-base remains limited. Such differences should be considered when interpreting research and surveillance findings.</abstract><cop>England</cop><pub>Oxford Publishing Limited (England)</pub><pmid>23478206</pmid><doi>10.1093/eurpub/ckt028</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1101-1262 |
| ispartof | European journal of public health, 2013-12, Vol.23 (6), p.1053-1058 |
| issn | 1101-1262 1464-360X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1504417490 |
| source | OUP_牛津大学出版社OA刊; PAIS Index; PubMed Central |
| subjects | AIDS Serodiagnosis - standards Anti-HIV Agents - administration & dosage Anti-HIV Agents - therapeutic use Benzoxazines - administration & dosage Benzoxazines - therapeutic use Childbirth & labor Comparative studies Cross cultural studies Data Collection Delivery, Obstetric - standards Disease transmission Drugs Europe Female France Health care policy Health policy HIV HIV Infections - prevention & control HIV Infections - transmission Human immunodeficiency virus Humans Infant, Newborn Infectious Disease Transmission, Vertical - prevention & control Maternal & child health Medical service Netherlands Practice Guidelines as Topic Pregnancy Pregnancy Complications, Infectious - drug therapy Prenatal Care - methods Prenatal Care - standards Public health Questionnaires Surveillance Surveys Surveys and Questionnaires Ukrainians United Kingdom Vagina Women Zidovudine - administration & dosage Zidovudine - therapeutic use |
| title | National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ? |
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