Survival and disease progression in human immunodeficiency virus-infected women after an index delivery.
OBJECTIVE
Our objective was to provide information on survival and disease progression in human immunodeficiency virus antibody-positive pregnant women undergoing prospective evaluation.


METHODS
After an index delivery, 103 human immunodeficiency virus antibody-positive pregnant women were identified and underwent follow-up for 3 years. The patients were assessed medically and/or gynecologically when hospitalized for a human immunodeficiency virus-related illness or at each follow-up visit. The life-table method was used to estimate the cumulative probabilities of survival and remaining free of acquired immunodeficiency syndrome. Cox's proportional-hazards analyses were used to identify prognostic factors for survival and progression to acquired immunodeficiency syndrome.


RESULTS
The majority of human immunodeficiency virus-infected pregnant women were alive 3 years later. Lymphadenopathy syndrome or herpes genitalis was significantly associated with a subsequent diagnosis of acquired immunodeficiency syndrome. Of the 103 original patients, six had acquired immunodeficiency syndrome at the index delivery and acquired immunodeficiency syndrome developed in 24. Approximately 94% of evaluable patients with development of acquired immunodeficiency syndrome had CD4-lymphocyte counts < 200/mm3. The most common opportunistic infection was Pneumocystis carinii pneumonia. Acquired immunodeficiency syndrome and postpartum zidovudine therapy were independent prognostic factors affecting survival.


CONCLUSIONS
Survival was affected by Centers for Disease Control group status of human immunodeficiency virus infection at the index delivery.
Department of Obstetrics and Gynecology, University of Miami School of Medicine/Jackson Memorial Medical Center, Florida.
D J
DJ
Gloeb
S
S
Lai
J
J
Efantis
M J
MJ
O'Sullivan
D000386:AIDS-Related Complex / Q000401:mortality; D017088:AIDS-Related Opportunistic Infections; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D015496:CD4-Positive T-Lymphocytes; D002180:Candidiasis, Oral / Q000150:complications; D005260:Female; D006679:HIV Seropositivity / Q000401:mortality*; D006801:Humans; D007958:Leukocyte Count; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality*; D011446:Prospective Studies; D015996:Survival Rate; D015215:Zidovudine / Q000627:therapeutic use
D015215:Zidovudine