title: Responding to her question: a review of the influence of pregnancy on HIV disease progression in the context of expanded access to HAART in sub-Saharan Africa.
abstract: In 2007, sub-Saharan Africa was home to over half of all women living with HIV. The vast majority of these women are of reproductive age, which raises concerns about the high incidence of pregnancy. As access to antiretroviral treatment is rapidly scaled up, two important questions must be answered: (1) Does pregnancy impact HIV disease progression?; (2) Does pregnancy modify the highly active antiretroviral therapy (HAART) response on HIV disease progression? A systematic review of the biomedical literature was conducted and seven relevant studies were identified. To date, it appears that there is no effect of pregnancy on HIV disease progression. Furthermore, initial studies in high-income countries suggest that pregnancy may positively modify the HAART response. These findings, however, must be interpreted with caution as it remains unclear how other factors, such as adherence, may influence the relationship between pregnancy, HIV disease progression, and HAART.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. smaccarthy@hsph.harvard.edu
authors.forename: Sarah
authors.initials: S
authors.lastname: MacCarthy
authors.forename: Fatima
authors.initials: F
authors.lastname: Laher
authors.forename: Mzikazi
authors.initials: M
authors.lastname: Nduna
authors.forename: Lindiwe
authors.initials: L
authors.lastname: Farlane
authors.forename: Angela
authors.initials: A
authors.lastname: Kaida
mesh_terms: D017954:Africa South of the Sahara; D023241:Antiretroviral Therapy, Highly Active; D002986:Clinical Trials as Topic; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology; D015497:HIV-1; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology