The relationship of pregnancy to human immunodeficiency virus disease progression - 28/08/11
, Ron Hershow, MD b, D.Heather Watts, MD c, Margaret Frederick, PhD d, Irene Cheng, MS d, Ruth Tuomala, MD e, Jane Pitt, MD f, Carmen D Zorrilla, MD g, Hunter Hammill, MD h, Samuel K Adeniyi-Jones, MD, PhD i, Bruce Thompson, PhD d
Reprint requests: Dr Howard Minkoff, Maimonides Medical Center, 967 48th St, Brooklyn, NY 11219.Brooklyn and New York, NY, Chicago, Ill, Bethesda and Baltimore, Md, Boston, Mass, San Juan, Puerto Rico, and Houston, Tex
Abstract |
OBJECTIVE: This study was undertaken to determine the effect of pregnancy on progression of human immunodeficiency virus (HIV) disease.
STUDY DESIGN: We compared the immunologic, clinical, and virologic courses of 953 women who had no additional pregnancy after their index pregnancy, with the courses of 329 women who had a second pregnancy subsequent to their index pregnancy. Baseline variables included use of antiretroviral therapy, and CD4 and HIV RNA values. A linear spline growth curve model was used to describe trajectories of variables. The Cox proportional hazards model was used to assess selected covariates on the time to development of clinical class C events or death.
RESULTS: Women with repeat pregnancies were less likely to be on antiretroviral therapy at baseline and had a higher CD4% count immediately after their first delivery. The average trajectory of CD4 values in the one-pregnancy group was almost identical to the average trajectory in the repeat pregnancy group. RNA levels in the single-pregnancy group started higher but ended lower than in the second-pregnancy group, although slope differences were modest. There were no significant differences in time to class C events, although women in the repeat-pregnancy group tended to survive longer.
CONCLUSION: Repeat pregnancies do not have significant effects on the course of HIV disease.
Le texte complet de cet article est disponible en PDF.Keywords : Human immunodeficiency virus, pregnancy, women, human immunodeficiency virus-1 RNA, CD4 cell count
Plan
 | A complete list of principal investigators, study coordinators, program officers, and funding appears at the end of the article. |
Vol 189 - N° 2
P. 552-559 - août 2003 Retour au numéro
Article précédent
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