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HIV-positive pregnant women can now have vaginal delivery –NACA

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By Francesca Hangeior.

 

Now, pregnant women living with the Human Immunodeficiency Virus who are on Antiretroviral Therapy and have a low or undetectable viral load can have a vaginal delivery, says the National Agency for the Control of AIDS.

In as much as HIV can pass to the infant during birth, NACA said the risk of transmission is low in women with virally suppressed loads.

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The agency noted that the advances in HIV treatment have greatly lowered the chances that a birthing parent would pass HIV on to their baby (also known as perinatal HIV transmission, vertical transmission, and sometimes called ‘mother-to-child’ transmission).

According to NACA, Nigeria has the highest burden of children born with HIV in the world.

It, however, warned that HIV can be transmitted from an infected mother to her child during pregnancy, childbirth, and breastfeeding if she is not on treatment.

The Deputy Director, Community Prevention and Care Department, NACA, Dr Yewande Olaifa, said for many years now, pregnant women living with HIV have been giving birth vaginally and not only through caesarean sections.

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Olaifa said, “Yes, for over a decade now, vaginally, women can deliver unless it is contraindicated because of obstetrics matters.

“But as long as there is no contraindication, she can deliver per vaginal irrespective of the fact that she is HIV positive.

“What is important is that if she is HIV positive, she is on treatment not only for herself but also for the baby. So if we can bring the viral load down with ART, the probability that she will transmit to the baby is limited.”

The American College of Obstetricians and Gynaecologists also affirms that 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.

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Speaking further, the deputy director said it is also compulsory to test all pregnant women for HIV when they come to for antenatal clinic, stressing that it helps in the prevention of motor-to-child transmission of the disease.

According to the World Health Organisation, without any intervention, the risk of HIV transmission from a mother to her child during pregnancy, labour, delivery, or breastfeeding can be as high as 45 per cent.

As such, the WHO states that the identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed, as well as an offer of partner services.

Nigeria faces a critical challenge in PMTCT of HIV and ensuring access to care for children living with HIV.

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According to NACA, its epidemiological estimates indicate that 140, 000 children under 14 are living with HIV as of 2023, with 22,000 new infections and 15,000 AIDS-related deaths in children.

The agency disclosed that current PMTCT and paediatric HIV coverage remain alarmingly low at less than 33 per cent, far short of the 95 per cent target.

Meanwhile, the Joint United Nations Programme on HIV/AIDS established the 95-95-95 targets calling for 95 per cent of all people living with HIV to know their HIV status, 95 per cent of all people with diagnosed HIV infection to receive sustained antiretroviral therapy, and 95 per cent of all people receiving antiretroviral therapy to have viral suppression by 2030.

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Frequent ejaculation not certain to prevent prostate cancer – Urologists

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The Association of Urological Surgeons in Nigeria, NAUS, has expressed concern about the recent and continued circulation in the public space of what it labelled as misinformation on social media and mainstream media regarding the link between frequent ejaculation and the risk of prostate cancer.

In a position statement on “Risk of Prostate Cancer and Frequency of Ejaculation” obtained by Vanguard, the executive committee of the NAUS – a professional organisation dedicated to advancing the field of urology in Nigeria – noted that while some studies have explored a potential correlation between increased ejaculation frequency and a reduced risk of prostate cancer, the evidence remains inconclusive, and more research is needed to fully understand the connection.

The statement – CAC/TT/No. 125351 – dated December 16, 2024, and jointly signed by the Association’s President, Prof. N.K. Dakum, and Secretary General, Prof. Muhammed Ahmed, cautioned that at this time, it is important to interpret the existing evidence carefully, and frequent ejaculation should not be seen as a guaranteed way to prevent prostate cancer.

The Association said that as a body of experts, it had a sense of duty to clarify the claims to prevent the spread of misleading information regarding ejaculation and prostate cancer risk

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The statement reads: The Association of Urological Surgeons, Nigeria (NAUS) has observed with concern the recent and continued dissemination of information on social media platforms and even the main stream media in Nigeria regarding the relationship between sex/frequent ejaculation and the risk of prostate cancer.

“There is a need, as professionals in the field to make a statement in that regard in order to avoid the perpetuation of often misleading and inaccurate statements or conclusions.

“We, therefore, wish to state that while there are studies suggesting a potential association between frequent ejaculation and reduced prostate cancer risk, the evidence is not yet conclusive, and more research is needed to fully understand the relationship between the two.

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NAFDAC raises the alarm over fake Paludex drugs, uncovers counterfeit hub in Aba

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NAFDAC has warned Nigerians about the sale and distribution of fake Paludex tablets and suspensions across the country.

The agency announced on its X account (formerly Twitter) that fake Paludex Artemether/Lumefantrine tablets (80mg/480mg) were falsely labelled as being made by Impact Pharmaceutical Ltd, located at Standard Industrial Layout, Emene, Enugu State.

It added that these fake drugs are being distributed by MD Life Sciences Ltd, also based in Emene Industrial Layout, Enugu.

NAFDAC further revealed the discovery of counterfeit Paludex dry powder for oral suspension (180mg/1080mg), meant for children.

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NAFDAC stated that the counterfeit Paludex oral suspension was falsely labelled as being manufactured by Impact Pharmaceutical Ltd, located at No. 33A/33B Standard Industrial Layout, Enugu, and Ecomed Pharma Limited in Ogun State, and marketed by MD Life Sciences Ltd.

The agency revealed that laboratory tests conducted by a WHO-prequalified laboratory in Germany showed that both products contained zero per cent of the Active Pharmaceutical Ingredients (API). Additional tests conducted by NAFDAC also confirmed the absence of any API in the products.

The statement further disclosed that the fake products are not listed in NAFDAC’s database of registered drugs, and the NAFDAC registration numbers displayed on the packaging are fake.

NAFDAC emphasized that authentic Artemether/Lumefantrine tablets or suspensions are a combination of two active ingredients, Artemether and Lumefantrine, used for treating acute, uncomplicated malaria in both adults and children.

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“The illegal marketing of medicines or counterfeit medicines poses a great risk to the health of people.

“By not complying with the regulatory provisions, the safety, quality, and efficacy of the products are not guaranteed.

“Also, poor-quality pediatric formulations or medicines in general have the potential of causing treatment failure when the API content is below the prescribed dose,” it said.

NAFDAC said that all its zonal directors and state coordinators have been directed to carry out surveillance and mop up the fake products within their zones and states.

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It also implored distributors, healthcare providers, and patients to exercise caution and vigilance within the supply chain to avoid distribution, administration, and use of the products.

The agency said that all medical products must be obtained from authorised/licensed suppliers.

“The products’ authenticity and physical condition should be carefully checked.

“Anyone in possession of any of the above-mentioned products is advised to immediately discontinue the sale or use and submit stock to the nearest NAFDAC office.

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The agency advised the public, especially those who have used any of the products to seek immediate medical advice from a qualified healthcare professional.

It also advised healthcare professionals and consumers to report any suspicion of substandard and falsified medicines to the nearest NAFDAC office, NAFDAC on 0800-162-3322 or via email: [email protected].

In another development, NAFDAC also identified Eziukwu Market, also known as Cemetery Market in Aba, Abia State, as a major hub for producing and distributing fake and substandard products.

This discovery followed an operation led by NAFDAC’s South-East Zonal Director, Martins Iluyomade, on Tuesday.

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During the operation, Iluyomade described the market as a centre for large-scale production and distribution of counterfeit goods, comparing its impact to “weapons of mass destruction.” Despite earlier raids, including a major one in December 2023, the illegal activities have persisted.

Iluyomade expressed frustration that people continue to prioritize profits over public health and safety. He also pointed out that the market leaders had previously signed an agreement with NAFDAC during the last operation, promising to expose those involved in these illegal activities.

However, he stressed that the market’s leadership must now answer serious questions about their failure to stop the production and sale of fake products.

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‘Blessed’: US Woman Sees Second Chance In Life After Pig Kidney Transplant

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Towana Looney donated a kidney to her mother in 1999 only for the remaining one to fail years later due to pregnancy complications.

Now, the 53-year-old from Alabama has become the latest recipient of a gene-edited pig kidney — and is currently the only living person in the world with an animal organ transplant, New York’s NYU Langone hospital announced Tuesday.

“I’m overjoyed, I’m blessed to have received this gift, this second chance at life,” Looney said during a press conference, held three weeks after the procedure.

Xenotransplantation, transplanting organs from one species to another, has long been a tantalizing yet elusive scientific goal. Early experiments on primates faltered, but recent advances in gene editing and immune system management have brought the dream closer to reality.

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Pigs have emerged as the ideal donors: they grow quickly, produce large litters and are already part of the human food supply.

Advocates hope this approach can help address the severe organ shortage in the United States, where more than 100,000 people are waiting for transplants, including over 90,000 in need of kidneys.

A last chance

Looney had been living with dialysis since December 2016 — eight grueling years. High blood pressure caused by preeclampsia had taken its toll, leaving her with chronic kidney disease.

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Despite receiving priority on transplant waiting lists as a living donor, her search for a compatible kidney was a frustrating dead end. Her unusually high levels of harmful antibodies made rejection almost inevitable, and as her body lost viable blood vessels to support dialysis, her health declined.

Out of options, Looney applied to join a clinical trial for pig kidney transplants, and finally underwent the seven-hour surgery on November 25.

Asked how she felt afterward, Looney’s joy was infectious. “I’m full of energy, I’ve got an appetite… and of course, I can go to the bathroom. I haven’t been going in eight years!” she laughed, adding that she plans to celebrate at Disney World.

Jayme Locke, a surgeon on the transplant team, described the results with awe. “The kidney functioned essentially exactly like a kidney from a living donor,” she said, adding that Looney’s husband saw a rosiness in her cheeks for the first time in years.

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“That is the miracle of transplantation.”

Cautious optimism

Looney’s surgery is the third time a gene-edited pig kidney has been transplanted into a human who is not brain dead.

Rick Slayman, the first recipient, died in May, two months after his procedure at Massachusetts General Hospital. The second, Lisa Pisano, initially showed signs of recovery following her surgery at NYU Langone, but the organ had to be removed after 47 days, and she passed away in July.

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Looney, however, was not terminally ill before the transplant, noted Robert Montgomery, who led the surgery. Each case, he emphasized, provides critical lessons for refining the techniques.

The kidney was provided by biotech company Revivicor, which breeds genetically modified herds in Virginia. A Massachusetts-based company, eGenesis, provided the kidney for Slayman.

Looney’s organ has 10 genetic edits to improve compatibility with the human body — an advance over Revivicor’s earlier efforts that used kidneys with a single gene edit and included the pig’s thymus gland to help train the host’s immune system and prevent rejection.

Montgomery, a pioneer in the field who performed the world’s first gene-edited pig organ transplant in a brain-dead patient in 2021, said both methods are likely to enter clinical trials “probably by this time next year, or even sooner.”

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“This is a watershed moment for the future of transplantation,” said Kevin Longino, CEO of the National Kidney Foundation. The nonprofit’s polling shows that patients and families favor faster clinical trial progress, believing the risk of inaction outweighs the uncertainties of xenotransplantation.

Looney was discharged December 6 to a nearby New York City apartment. Though her high antibody levels remain a concern, doctors are monitoring her closely using wearable technology and are trying a novel drug regimen to prevent rejection.

Periodic hospital visits may still be required, but the team remains optimistic she can return home in three months.

AFP

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