What They Stated Regarding Isotretinoin Is certainly Extremely Wrong

Current practice guidelines for routine STI screening in pregnancy recommend screening at entry to prenatal care and, then in regards to chlamydia, women Isotretinoin should be screened again in the third trimester [7]. However, the results of our study suggests that there may be a role for routine second trimester STI screening in HIV infected women as well since the majority of STIs in our study were detected in the second trimester. In addition, to enhance STI screening it is important for health care providers to encourage condom use and safe sex practices in their HIV infected pregnant patients. Health care providers should educate patients on signs and symptoms of STIs during pregnancy. Women diagnosed with STIs need close follow-up and test of cures to ensure adequate treatment. Prevention and early treatment of STIs may decrease the risk of spontaneous preterm birth among HIV positive women. Our study has several strengths. First, this study reports a well characterized cohort. HIV infected women were prospectively identified and data was collected on women who received prenatal care at the same hospital and by the same physicians. Second, this was a contemporary managed HIV infected population as over 95% of women in each cohort were maintained on combination antiretroviral therapy. Finally, Cell Cycle inhibitor multivariate analysis was performed to adjust for potential confounders that could influence the risk of spontaneous preterm birth. Our study also has several limitations. A major limitation is that the diagnosis of HPV infection was presumptive and based on the presence of an abnormal pap test. Studies do however show a strong association (97�C99%) between cervical dysplasia and the presence of HPV infection [15, 16]. Another limitation of our study is potential misclassification as women who had negative cytology and no STIs may have had HPV Kinase Inhibitor Library infection. However, this misclassification would be in the direction of the null hypothesis and should not have appreciably impacted our results. Finally, there may be unknown confounder that exists and were not controlled for in the multivariable analysis. In conclusion, HIV infected women were found to have a 2-fold increased risk of spontaneous preterm birth when they were coinfected with an STI during pregnancy. Therefore enhanced STI screening with tests of cure, along with safe sex counseling, are vital steps in potentially mitigating adverse outcome in HIV infected pregnant women. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.""Advances in HIV treatment and reductions in perinatal HIV transmission have led to improved quality of life and increased pregnancies among women with HIV [1].