The European Collaborative Study: clinical and immunological characteristics of HIV 1-infected pregnant women.
OBJECTIVE
To describe the changing clinical and immunological characteristics and timing of diagnosis of HIV-infected pregnant women enrolled in the European Collaborative Study.


METHODS
A prospective study of the mothers of children enrolled in the European Collaborative Study on children born to HIV-infected women.


METHODS
Twenty-one European centres in seven countries.


METHODS
One thousand six hundred and ninety HIV-infected women and their 1754 deliveries.


RESULTS
The proportion of women in whom HIV infection had been diagnosed before pregnancy increased significantly over time, from 7% in 1984-1985 to 65% in 1994 (P < 0.001). The prevalence of breastfeeding, which was related to the timing of diagnosis, significantly declined over the study period. The mean CD4 count was 510 cells/mm3, and there was a significant decline in average CD4 count over the study period. Black women had a significantly lower CD4 count than white women. From survival analysis it is estimated that five years after delivery 14% of women will have died and 24% will have developed CDC stage IV disease.


CONCLUSIONS
Timing of diagnosis is of critical importance if mother-to-child transmission is to be reduced through avoidance of breastfeeding and zidovudine therapy and effective antenatal screening policies have become increasingly important. The rate of progression of maternal disease highlights the implications of HIV infection for their children, both infected and uninfected.
Epidemiology and Biostatistics Unit, Institute of Child Health, London, UK.
C
C
Thorne
M L
ML
Newell
D
D
Dunn
C
C
Peckham
D000998:Antiviral Agents / Q000627:therapeutic use; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D015999:Multivariate Analysis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D015215:Zidovudine / Q000627:therapeutic use
D000998:Antiviral Agents; D015215:Zidovudine