Pregnant women with HIV infection can expect healthy survival: three-year follow-up.
OBJECTIVE
To document postpartum disease-free survival of HIV-infected women taking antiretroviral therapy (ART) during pregnancy.


METHODS
Laboratory and clinical data were collected on all HIV-infected pregnant women delivering from 1998 to 2002 and followed up until September 2004 at 6 hospitals in London. Mothers were grouped according to receipt of zidovudine monotherapy (ZDVm), highly active antiretroviral therapy (HAART) given during and continued after pregnancy (cHAART), and short-term HAART given during pregnancy and discontinued on delivery (START).


RESULTS
Eight-five women took ZDVm, 155 took cHAART, and 71 took START. The mean follow-up for all mothers was 33 months, with a total of 847 person-years. At the first antenatal clinic (ANC) visit, 72% of women were in Centers for Disease Control and Prevention (CDC) stage A, 85% were treatment naive, and the ZDVm group had a median HIV viral load (VL) 10-fold less than those mothers who started HAART during pregnancy. At last follow-up, 1 patient had died and 6 (1.9%) had progressed to CDC stage C; 62% of all women, including a quarter of the ZDVm group, were receiving HAART for their own health; and 83% of all mothers had a VL <50 HIV RNA copies/mL of plasma regardless of whether they were on treatment or not.


CONCLUSIONS
The median-term postpartum prognosis of HIV-infected pregnant women with access to HAART is good. Exposure to short-course ZDVm or START during pregnancy did not jeopardize their response to subsequent therapy.
Martin
Fabiola
F
St. Mary's NHS Trust, London, United Kingdom. fabiolaaghakhani@yahoo.co.uk
Navaratne
Lesley
L
Khan
Wahid
W
Sarner
Liat
L
Mercey
Danielle
D
Anderson
Jane
J
Noble
Heather
H
Fakoya
Ade
A
Hawkins
David A
DA
De Ruiter
Annemiek
A
Taylor
Graham P
GP
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008485:Medical Audit; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D037841:Pregnant People; D015215:Zidovudine / Q000009:adverse effects* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine