期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 189, 期 2, 页码 552-559出版社
MOSBY, INC
DOI: 10.1067/S0002-9378(03)00467-8
关键词
human immunodeficiency virus; pregnancy; women; human immunodeficiency virus-1 RNA; CD4 cell count
资金
- NCRR NIH HHS [RR00645, RR00188] Funding Source: Medline
- NIAID NIH HHS [U01 AI 34858, U01 AI 34841, 1 U01 AI 50274-01, N01 AI 85339] Funding Source: Medline
- NICHD NIH HHS [U01 HD 36117, U01 HD 41983] Funding Source: Medline
- NIDA NIH HHS [U01 DA 15053, 9U01 DA 15054] Funding Source: Medline
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.
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