The relationship of pregnancy to human immunodeficiency virus disease progression.
OBJECTIVE
This study was undertaken to determine the effect of pregnancy on progression of human immunodeficiency virus (HIV) disease.


METHODS
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.


CONCLUSIONS
Repeat pregnancies do not have significant effects on the course of HIV disease.
Minkoff
Howard
H
Department of Obstetrics and Gynecology, Maimonides Medical Center and SUNY Downstate, Brooklyn, New York 11219, USA. Hminkoff@maimonidesmed.org
Hershow
Ron
R
Watts
D Heather
DH
Frederick
Margaret
M
Cheng
Irene
I
Tuomala
Ruth
R
Pitt
Jane
J
Zorrilla
Carmen D
CD
Hammill
Hunter
H
Adeniyi-Jones
Samuel K
SK
Thompson
Bruce
B
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D036861:Delivery, Obstetric; D005260:Female; D020073:Gravidity; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D016019:Survival Analysis
D012367:RNA, Viral