What to expect in a case of 31-year-old female having fetus with right sided aortic arch?
A 31-year-old, gravida 3, parity 1, abortion 1, pregnant woman underwent prenatal routine second mid-trimester ultrasonography in the 22nd week of her pregnancy for foetal anatomic scan. Her pregnancy has continued uncomplicated until now and there was no prominent feature in her history. First trimester screening was normal and nuchal translucency was in normal limits. At sonographic foetal examination foetal anatomy was evaluated normal and foetal biometrics was compatible with gestational age. Four chamber views were defined normal, left ventricular and right ventricular output were defined normal at foetal cardiac examination. At 3VT plane aorta was located at the right side of trachea. Arrangement of the vessels was pulmonary artery, trachea, aorta, superior vena cava from left to the right. In colour Doppler, U shaped vascular ring is visualized around the trachea. No other abnormality is detected on cardiac examination beside right sided aortic arch. Have you ever come across such sonographic findings in a fetus?
A pregnant woman - fever and a bleeding tendency - next steps?
Gravida 1,31 weeks, 26 years, complaints of epigastric pain, bleeding per gum and petechiae hemorrhage for 1 day; high-grade fever for 5 days prior to admission, first seen at antenatal clinic (12 weeks pregnancy), no abnormality detected. Nothing history. 37°c, bp110/80 mmHg, pulse 80/mim and respiratory rate 20/min. Mild dehydration. Liver enlarged 1 cm below the right costal margin with mild tenderness. Fundal height - 31 weeks' gestation, fetal heart rate 144 beats/min, Petechiae1–2 mm d. found on face, forearms and both pretibial areas.
Labs: hgb 11.9 g/dl, hematocrit 35%, white blood cells 7,440/mm3 50% neutrophil, 45% lymphocytes; 3% atypical lymphocytes; platelet 10,100 /mm3. Intravenous fluid replacement, under close observation bleeding precaution. After 24h, epigastric pain disappeared, vital signs normal. Hematocrit 30% , platelet 6,320 /mm3. Day 3, gradually recovered and had an itching convalescent rash on both pretibial areas. Hematocrit 31%, platelet 15,000 /mm3. She was discharged day 4. After 1 week, she was healthy and hematocrit 32% with platelet 354,000 /mm3. After that, she had an uneventful antenatal care. At the 39 weeks' gestation, she delivered a healthy female baby weighing 2,630 grams by vaginal route with APGAR scores 9 and 10 at 1 and 5 minutes, respectively. No abnormality in newborn was detected.
Most likely diagnosis of this condition?
Canadian gynecologists concerned social media is reshaping perspectives about effective contraception methods
Look up #naturalbirthcontrol on Instagram and TikTok and you’ll find thousands of posts produced by young influencers encouraging women to ditch the pill and use other methods to avoid pregnancy – mainly by tracking their cycles on their cellphones. Other posts encourage women to avoid pregnancy through “fertility awareness,” which involves tracking bodily changes as a way to determine if they are fertile or not.
Some of the central arguments, which are not supported by science, include that hormonal contraception is unsafe and toxic. Canadian gynecologists say these social media videos, often misleading and created by individuals with large followings and no medical credentials, are reshaping conversations in their clinics, largely among twentysomethings. The physicians who specialize in reproductive health worry the content is connected to a shift in perspectives about effective, safe and long-standing contraceptive methods that have given generations of women and gender-diverse people agency over their reproductive health.
The Society of Obstetricians and Gynaecologists of Canada issued a statement last fall outlining its concerns about social media influencers promoting fertility tracking apps as substitutes for hormonal contraception.The technology has been criticized by medical professionals who say it is not reliable to avoid pregnancy. The SOGC said social-media content is being used to undermine trust in health care providers and treatment options and is creating confusion for patients. It has called mis- and disinformation on women’s health a “growing threat.”
Dr. Black says one of the challenges for health care providers is to ensure they address misperceptions that are circulating so patients can make informed decisions based on the best available science. She has now distilled her response to misperceptions into about 15 seconds. Dr. Black debunks myths including that the pill makes people infertile. She knows it is important to counsel patients because if concerns are left unaddressed, individuals may not want to fill prescriptions, even if they leave the clinic with them in hand.
Earlier this month, the Center for Intimacy Justice released a report that found tech platforms including Meta, Amazon, Google and TikTok are “systematically suppressing sexual and reproductive health information for women and people of diverse genders.” Sexual health professionals fear an uptick of non-scientific information shared on social media, particularly among young people, could result in unwanted pregnancies...Read more
What do you think about this? Do you agree with Dr. Black?
Diabetes, Dyslipidemia Screening Rates Low After Pregnancy, Even for Those With HTN, GDM
Patients with pregnancy-related hypertension (HTN) or diabetes are more likely to be screened for diabetes and dyslipidemia after delivery, but screening rates remain low for those with and without HTN and diabetes, according to a research letter published online Feb. 17 in Circulation.
Amy Y.X. Yu, M.D., from the University of Toronto, and colleagues conducted a population-based cohort study and compared postpartum screening for diabetes and dyslipidemia among patients with and without hypertensive disorders of pregnancy or gestational diabetes (GDM). A total of 1,265,015 pregnant patients younger than 50 years who were discharged alive after admission for a live birth, stillbirth, or intentional pregnancy termination after ≥20 completed weeks of gestation were identified.
The researchers found 165,660 patients (13.1 percent) had pregnancy-related hypertension or diabetes, which was the main exposure. Among exposed patients, 81.1 percent had pregnancy-related hypertension or diabetes during the index pregnancy, and the rest were exposed during a previous pregnancy. Compared with unexposed patients, exposed patients were more likely to be screened for diabetes and dyslipidemia within three years, but the difference was moderate and both groups had low screening rates (43.8 versus 33.0 percent; relative risk [RR], 1.33). Screening within one year was also low (17.3 percent exposed versus 11.1 percent unexposed; RR, 1.56). Screening was lower for dyslipidemia within three years than for diabetes (RRs, 1.32 versus 1.19). During the 17-year study period, screening practices remained relatively similar.
"Suboptimal vascular risk factor screening after pregnancy-related hypertension or diabetes is a missed opportunity for cardiovascular prevention," the authors write.
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Sisters of Those With Adverse Pregnancy Outcome Also Have Increased CVD Risk
Women with adverse pregnancy outcomes (APOs) have an increased risk for cardiovascular disease (CVD), as do their APO-free sisters, according to a study published online Feb. 7 in the European Heart Journal.
Ängla Mantel, M.D., Ph.D., from Karolinska Institute in Stockholm, and colleagues conducted a nationwide population-based cohort study involving primiparous women without prior CVD with registered singleton births between 1992 and 2019. Participants were classified as women with one or more APOs (165,628), APO-free sisters (60,769), and unrelated APO-free comparators (992,108). Participants were followed longitudinally from delivery until 2021 for the primary end point of major adverse cardiac events.
The researchers found that APO-exposed women had increased rates of CVDs relative to APO-free comparators during a median follow-up of 14 years. Compared with APO-free comparators, APO-free sisters had increased adjusted hazard ratios of major adverse cardiac events, heart failure, and cerebrovascular events (adjusted hazard ratios, 1.39, 1.65, and 1.37, respectively); there was no significant increase in ischemic heart disease. Lower CVD rates were seen in APO-free sisters versus their APO-exposed counterparts in a within-family analysis, apart from cerebrovascular events, which did not differ significantly.
"Implementation of tailored preventive strategies for both women with APOs and women with heredity for APOs is paramount in mitigating the heightened CV risk within this vulnerable population," the authors write.
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Maternal Health in Pregnancy Tied to Risk for Autism in Offspring
Maternal health in pregnancy is associated with offspring autism, and these associations are largely attributed to familial confounding, according to a study published online Jan. 31 in Nature Medicine.
Vahe Khachadourian, M.D., Ph.D., M.P.H., from the New York University Grossman School of Medicine in New York City, and colleagues examined the likelihood of autism associated with various maternal prenatal diagnoses, accounting for disease chronicity and comorbidity, familial correlations, and sociodemographic factors.
Overall, 1.6 percent of the 1,131,899 individuals in the sample were diagnosed with autism by the end of follow-up. The researchers found that after accounting for sociodemographic factors, disorder chronicity, and comorbidity and after correcting for multiple testing, 30 of the 236 maternal diagnoses tested were significantly associated with autism, including obstetric, cardiometabolic, and psychiatric disorders, which have previously been associated with autism. In the majority of the observed associations, family-based analyses provided strong evidence for familial confounding.
"Our findings draw attention to the importance of maternal health around pregnancy and reinforce the notion that many of the observational associations between perinatal factors and offspring neurodevelopment are likely noncausal in nature," the authors write.
One author is currently employed by Takeda Pharmaceutical Company.
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Offspring of Women With Epilepsy Experience Decreased Bone Metabolism
Women with epilepsy may have offspring with decreased bone metabolism and lower birth weight, according to a study published online Feb. 3 in the Annals of Clinical and Translational Neurology.
Huali Luo, from Zhejiang University in China, and colleagues retrospectively analyzed data from 83 parturients with epilepsy receiving antenatal care (2012 through 2021) and a control group of 249 parturients without epilepsy.
The researchers found that women with epilepsy were significantly more likely to undergo a cesarean section with a lower abortion rate (55.4 versus 37.3 percent). Offspring femoral length in women with epilepsy was significantly reduced versus the control group (6.812 versus 6.923 cm) when adjusting for potential confounding variables. Compared with offspring whose mothers used a single antiseizure medication (ASM) or none, those born to mothers using multiple ASMs had significantly reduced femoral and biparietal lengths. Additionally, using multiple ASMs was associated with significantly lower birth weight in offspring versus women not using ASMs.
"The application of a single ASM during pregnancy is the optimal choice for pregnant women with epilepsy and their offspring, as it can not only control the seizures to reduce the harm caused by seizures during pregnancy but also minimize the restriction of ASMs on the growth and development of offspring," the authors write.
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Prenatal Alcohol Exposure Linked to Facial Development at Age 6 to 8 Years
Prenatal alcohol exposure is associated with facial development, and the associations persist to age 6 to 8 years, according to a study published online Feb. 10 in JAMA Pediatrics.
Evelyne Muggli, M.P.H., from Murdoch Children's Research Institute in Parkville, Australia, and colleagues conducted a prospective cohort study starting in July 2011 with follow-up through April 2021 to examine whether subtle changes in facial shape with prenatal alcohol exposure found in 12-month-old children were seen at 6 to 8 years of age. Three-dimensional craniofacial images from 549 children of European descent were taken at age 12 months and 6 to 8 years (421 [336 with any prenatal alcohol exposure and 85 control] and 363 [260 with any prenatal alcohol exposure and 103 control] images, respectively); 235 children contributed an image at both time points.
The researchers found consistent evidence for an association between prenatal alcohol exposure and the shape of the eyes and nose at both time points, whether exposure occurred only in trimester 1 or throughout pregnancy. Facial variations were different from those in the clinical discovery sample of facial images of children with a confirmed diagnosis of partial or full fetal alcohol syndrome.
"A linear association between the level of prenatal alcohol exposure and variation in facial shape was not supported, most likely due to a complex association between prenatal alcohol exposure dose and timing and the many molecular pathways affected by alcohol," the authors write.
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Early Childhood Sun Exposure Linked to Lower Risk for Pediatric MS Relapse
Greater prenatal and early childhood sun exposure is associated with a lower risk for relapse among children with multiple sclerosis (MS), according to a study published online Feb. 12 in Neurology: Neuroimmunology & Neuroinflammation.
Gina Chang, M.D., M.P.H., from The Children's Hospital of Philadelphia, and colleagues conducted a multicenter cohort study involving 334 children with pediatric-onset MS recruited from 18 pediatric MS clinics between Nov. 1, 2011, and July 1, 2017, to examine the correlation between time spent in the sun in early childhood and risk for relapse. Relapses were identified prospectively after enrollment; those preceding study enrollment were entered retrospectively.
The researchers found that from disease onset to the end of the follow-up period, 206 children (62 percent) experienced at least one relapse. Compared with <30 minutes, ≥30 minutes of daily sun exposure during the first summer of life was associated with a lower risk for relapse after adjustment (adjusted hazard ratio, 0.67). There was also an association seen between greater time spent in the sun during the first trimester of pregnancy and a reduced risk for relapse (adjusted hazard ratio, 0.68). No significant associations were seen for ultraviolet radiation dose and time spent in the sun later in life with relapse risk.
"Our findings suggest that sun exposure in early childhood may have long-lasting benefits on the progression of childhood-onset MS," Chang said in a statement.
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Possible Listeria Contamination Prompts Recall of 2 Million Baked Goods
About 2 million baked goods have been recalled over concerns of potential contamination with Listeria monocytogenes, according to federal safety regulators.
The recall went into effect on Jan. 7, 2025, and was upgraded on Feb. 5 to a Class II recall, The New York Times reported. The manufacturer, FGF Brands, which distributes baked goods in the United States and Canada, said in a statement that the voluntary recall was "a precautionary measure based on non-product-related findings" at one of its doughnut facilities in the United States, adding that "no doughnuts or food contact surfaces ever tested positive for Listeria."
The company also noted that the recall was completed in early January, "and does not implicate anything that is currently, or was recently, on the market."
The recalled products include a mix of chocolate, raspberry, and Bavarian doughnuts; French crullers; eclairs; and coffee rolls. Some of the goods were sold at Dunkin’, and were produced before Dec. 13, 2024, according to The Times. No suspected source of the contamination has been identified.
Listeria bacteria causes listeriosis, the third leading cause of death from foodborne illness in the United States. Symptoms can include fever, muscle aches, and fatigue, according to the U.S. Centers for Disease Control and Prevention. An infection can also cause a stiff neck, a headache, confusion, or seizures.
Older adults, pregnant women, and people with weakened immune systems are the most vulnerable to infection. Listeria is especially dangerous for pregnant women and can cause pregnancy loss, premature birth, or a life-threatening infection in a newborn.
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Risk for Postpartum CVD Readmissions Higher for Twin Pregnancies
Twin pregnancies have increased risks for cardiovascular disease (CVD) readmissions in the first year postpartum, even in the absence of hypertensive disorders of pregnancy (HDP), according to a study published online Feb. 3 in the European Heart Journal.
Ruby Lin, M.D., from Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues estimated the rates of CVD readmission in twin deliveries with and without HDP and singleton deliveries with and without HDP using the Nationwide Readmissions Database of U.S. hospitals from 2010 to 2020.
The researchers found that the rates of CVD readmission in twin and singleton pregnancies were 1,105.4 and 734.1 per 100,000 delivery admissions, respectively, among 36 million delivery hospitalizations. Compared with singleton pregnancies without HDP, the adjusted hazard ratios for CVD readmissions were highest for twin pregnancies with HDP, followed by singleton pregnancies with HDP and twin pregnancies without HDP (hazard ratios, 8.21, 5.89, and 1.95, respectively).
"Our findings of increased heart disease and stroke in patients with twin pregnancies up to 12 months postdelivery should not be discounted despite the previous research showing no long-term increase in cardiovascular morbidity or mortality for twin pregnancies, given maternal mortality is associated with CVD," the authors write.
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ACP Issues Clinical Guideline for Pharmacologic Prevention of Episodic Migraine
In a clinical guideline issued by the American College of Physicians and published online Feb. 4 in the Annals of Internal Medicine, recommendations are presented regarding the use of pharmacologic treatments for the prevention of episodic migraine headache in nonpregnant adults in outpatient settings.
Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues examined the comparative effectiveness of medications that are beneficial for preventing episodic migraine to help clinicians select which medication to use.
The guidelines include three recommendations. Monotherapy to prevent episodic migraine headache in nonpregnant adults in outpatient settings is suggested by choosing one of the following: beta-adrenergic blocker (metoprolol or propranolol), the antiseizure medication valproate, the serotonin and norepinephrine reuptake inhibitor venlafaxine, or the tricyclic antidepressant amitriptyline. To prevent episodic migraine headache in nonpregnant adults in outpatient settings who do not tolerate or inadequately respond to a trial or trials of one of these medications, monotherapy with a calcitonin gene-related peptide (CGRP) antagonist-gepant or a CGRP monoclonal antibody is suggested. Monotherapy with the antiseizure medication topiramate is suggested to prevent episodic migraine for those who do not respond to the suggestions in recommendations 1 and 2. An informed decision-making approach should be used, and benefits, harms, costs, patient values and preferences, contraindications, pregnancy and reproductive status in females, clinical comorbidities, and medication availability should be discussed when selecting pharmacologic treatment.
"Adherence to pharmacologic treatment is crucial because improvement may occur gradually after initiation of a long-term treatment option for prevention of episodic migraine, with an effect that may become apparent after the first few weeks of treatment," the authors write.
Evidence Review 1 (subscription or payment may be required)
Evidence Review 2 (subscription or payment may be required)
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Low Vitamin D in First Trimester Tied to Worse Outcomes
Low vitamin D levels during the first trimester of pregnancy are associated with higher rates of preterm birth and decreased fetal length, according to a study published online in the February issue of the American Journal of Clinical Nutrition.
Celeste Beck, Ph.D., M.P.H., from Pennsylvania State University in University Park, and colleagues examined whether first- and second-trimester maternal vitamin D status was associated with fetal growth patterns and pregnancy outcomes. The analysis included 351 participants with vitamin D measurements taken at six to 13 and 16 to 21 weeks of gestation.
The researchers found that vitamin D insufficiency (25-hydroxyvitamin D [25(OH)D] <50 nmol/L) was prevalent in 20 percent of participants in the first trimester. In the first trimester, each 10 nmol/L increase in 25(OH)D was associated with a 0.05 increase in length-for-age z-score but was not associated with weight or head circumference. Using the cutoff of <50 nmol/L, there were no differences in the risk for preterm birth or small for gestational age. However, among participants with first-trimester 25(OH)D <40 nmol/L compared with ≥80 nmol/L, the risk for preterm birth was 4.35 times higher. There was no association for second-trimester 25(OH)D and fetal growth patterns or with pregnancy outcomes.
"This research indicates that vitamin D levels -- along with iron, folate, and other essential nutrients in pregnancy -- should be monitored and understood by obstetricians and women early on to promote healthy birth outcomes," Beck said in a statement.
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Live Birth Rate Lower With Frozen Versus Fresh Embryo Transfer
Frozen embryo transfer is associated with a lower live birth rate compared with fresh embryo transfer among women with a low prognosis for in vitro fertilization (IVF) treatment, according to a study published online Jan. 29 in The BMJ.
Daimin Wei, M.D., Ph.D., from Shandong University in Jinan, China, and colleagues conducted a pragmatic, multicenter, randomized controlled trial in nine academic fertility centers in China involving 838 women with a low prognosis for IVF treatment (defined by no more than nine oocytes retrieved or poor ovarian reserve). Participants were randomly assigned to undergo frozen or fresh embryo transfer on the day of oocyte retrieval. All embryos were cryopreserved in the frozen embryo transfer group, and participants underwent frozen embryo transfer later. In the fresh embryo transfer group, participants underwent fresh embryo transfer after oocyte retrieval.
The researchers found that the rate of live birth was lower in the frozen versus fresh embryo transfer group in the intention-to-treat analysis (32 versus 40 percent; relative ratio, 0.79). The rate of clinical pregnancy was also lower for the frozen embryo group versus the fresh embryo group (39 versus 47 percent; relative ratio, 0.83). The frozen versus fresh embryo transfer group had a lower cumulative live birth rate (44 versus 51 percent; relative ratio, 0.86). There were no differences in terms of birth weight, incidence of obstetric complications, or neonatal morbidity risk.
"Fresh embryo transfer may be a better choice for women with low prognosis for IVF in terms of live birth rate compared with frozen embryo transfer," the authors write.
One author disclosed ties to the biopharmaceutical industry.
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AI System Can Improve Detection of Congenital Heart Defects In Utero
Artificial intelligence (AI) can improve detection of congenital heart defects (CHDs) on routine prenatal ultrasounds, according to a study presented at The Pregnancy Meeting, the annual meeting of the Society for Maternal-Fetal Medicine, held from Jan. 27 to Feb. 1 in Denver.
Jennifer Lam-Rachlin, M.D., from the Icahn School of Medicine at Mount Sinai Hospital in New York City, and colleagues examined whether an AI system can improve detection of CHDs on fetal ultrasound exams among general obstetricians and gynecologists (OB-GYNs) and maternal-fetal medicine (MFMs) subspecialists. The AI system analyzed grayscale two-dimensional ultrasound cines of an exam and detected eight morphological findings associated with severe CHDs; the presence of any finding was sufficient to refer the patient for further examination. A dataset of 200 ultrasound exams from 11 centers was obtained; 100 exams had suspicious findings. Fourteen physicians (OB-GYNS and MFMs) reviewed each exam aided and unaided by the AI system in randomized order.
The researchers found that the receiver operating characteristic area under the curve for detection of any finding was significantly higher for AI-aided versus unaided reviews (0.97 versus 0.83). The results were similar for sensitivity (0.94 versus 0.78) and specificity (0.97 versus 0.76). The mean reading time was shorter for AI-aided versus unaided review (226 ± 218 versus 274 ± 241 seconds).
"Our findings show that the AI-based software significantly improved detection of ultrasounds that were suspicious for congenital heart defects not only among OB-GYNs but also among maternal-fetal medicine subspecialists," Lam-Rachlin said in a statement.
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Large Decrease Seen in Antidepressant Use During Pregnancy
There has been a large decrease in antidepressant use during pregnancy and no corresponding increase in psychotherapy claims, according to a research letter published online Jan. 30 in JAMA Network Open.
Claire Boone, Ph.D., from McGill University in Montreal, and colleagues measured antidepressant medication fills and psychotherapy claims of women and their spouses for two years before and two years after the birth of a child (2009 to 2019). The study included 385,731 women.
The researchers found that 4.3 and 2.2 percent of women filled an antidepressant prescription in the year before pregnancy and during pregnancy, respectively, a reduction of 48.8 percent. No similar change was seen in antidepressant use among 217,877 spouses, indicating that this behavior was not associated with co-occurring changes in the couple's life. During pregnancy, there was a slight decrease in psychotherapy claims related to a trend line. Women's mean medication fills returned to the prepregnancy trend line within one month of giving birth.
"We documented a large decrease in antidepressant use without an accompanying increase in psychotherapy during pregnancy," the authors write. "These findings, coupled with evidence of mental health challenges during and after pregnancy, suggest the need for increased focus on and discussion about mental health treatments by pregnant women and their clinicians."
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Temperature Exposure Linked to Adolescent Psychiatric Symptoms
Exposure to cold in the Netherlands and to heat in Spain appears to be associated with more psychiatric symptoms among adolescents, according to a study published online Jan. 28 in JAMA Network Open.
Esmée Essers, from ISGlobal in Barcelona, Spain, and colleagues analyzed data from the Dutch Generation R Study and the Spanish Infancia y Medio Ambiente (INMA) Project, which recruited 9,898 women during pregnancy or shortly after birth and 2,270 women during pregnancy, respectively, to examine the association of ambient temperature exposure with internalizing, externalizing, and attention problems in adolescents. The study included 3,934 participants from Generation R and 885 from INMA (mean age at assessment, 13.6 and 14.9 years, respectively).
The researchers found that in Generation R, the mean square-root transformed scores were 2.0 for internalizing, 1.6 for externalizing, and 1.5 for attention problems, while in INMA, these scores were 2.4, 2.1, and 1.5, respectively. Cumulative exposure to cold in the Netherlands was associated with more internalizing problems (e.g., 0.76 higher square-root points at 5.5 degrees Celsius over a two-month exposure). Cumulative exposure to heat in Spain was associated with more attention problems (e.g., 1.52 higher square-root points at 21.7 degrees Celsius exposure over a two-month exposure).
"This study helps quantify the intricate and multifactorial nature of the association of climate change with mental health and can be leveraged to provide evidence for adaption strategies and climate action policies," the authors write.
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Trump Administration Waives Halt on Distribution of HIV Medications Via PEPFAR
The Trump administration has made some concessions to the halt placed on distributions of global HIV treatments via the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), according to The New York Times.
Secretary of State Marco Rubio announced the waiver on Tuesday; however, exactly what it covers remains unclear. While the waiver does allow for the resumption of distributing HIV medications, the freeze on other services, including the distribution of preventive drugs, is still thought to be in place.
PEPFAR, a $7.5 billion program under the governance of the State Department, was due for a five-year reauthorization in 2023. After avoiding a Republican effort to end the program, it was renewed for one year, according to The Times. Data on the U.S. Centers for Disease Control and Prevention website indicate that more than 1 million Americans are living with HIV, with more than 30,000 becoming infected each year.
Americans would face serious consequences if PEPFAR is defunded, The Times reported. Without the availability of HIV medications in other countries, there is a higher risk for HIV developing resistance to current medications. Large populations of immunocompromised people could lead to easier spread of other pathogens, including dangerous COVID variants. Trials conducted with PEPFAR support have provided insight into the importance of early treatment of HIV, managing pregnancy and the virus, and preexposure prophylaxis and long-acting antiretrovirals.
"We can very rapidly return to where the pandemic is exploding, like it was back in the 1980s," Steve Deeks, M.D., an HIV expert at the University of California, San Francisco, told The Times. "This really cannot happen."
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