Prospective cohort study of the effect of pregnancy on the progression of human immunodeficiency virus infection. The Groupe d'Epidémiologie Clinique Du SIDA en Aquitaine.
OBJECTIVE
To study the prognostic role of pregnancy on the progression of human immunodeficiency virus (HIV) infection.


METHODS
In a prospective cohort study at the Bordeaux University Hospital, France, 57 women who completed a pregnancy during the course of their HIV infection were compared with 114 HIV-infected women who never conceived. The two groups were matched on CD4 lymphocyte count (CD4), age, and year of HIV diagnosis. The main outcome measures were death, occurrence of a first AIDS-defining event, and drop of the CD4 below 200/mm3.


RESULTS
The mean follow-up period in pregnant women was 61 months from HIV diagnosis (median CD4 at entry 455/mm3) and 54 months from beginning of pregnancy. Nonpregnant women were followed-up for 50 months since HIV diagnosis (median CD4 460/mm3). The proportion of asymptomatic women at entry in the study was 51 of 57 (90%) in pregnant and 87 of 114 (76%) in nonpregnant women. No significant difference was observed between the two groups with regard to the different end points studied, even after adjustment for other prognostic variables. Adjusted hazard ratios (pregnant/nonpregnant) were 0.92 for death (95% confidence interval [CI] 0.40-2.12), 1.02 for occurrence of a first AIDS-defining event (95% CI 0.48-2.18), and 1.20 for drop of the CD4 to less than 200/mm3 (95% CI 0.63-2.27).


CONCLUSIONS
In a cohort of HIV-infected women with mild to moderate immunosuppression, pregnancy did not accelerate progression to AIDS or death.
Hocke
C
C
Service de Gynécologie-Obstétrique, Hôpital Pellegrin, Centre Hospitalier Universitaire, Bordeaux, France.
Morlat
P
P
Chene
G
G
Dequae
L
L
Dabis
F
F
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000276:immunology / Q000401:mortality; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate