Treatment interruption after pregnancy: effects on disease progression and laboratory findings.
OBJECTIVE
To assess clinical progression and inflammatory markers among women stopping or continuing antiretroviral therapy (ART) after pregnancy.


METHODS
ART-naïve women with CD4+ lymphocyte counts >350 cells/uL initiating ART during pregnancy had clinical events and laboratory markers compared over one year postpartum between those stopping (n = 59) or continuing (n = 147) ART.


RESULTS
Slopes in CD4 count and HIV RNA did not differ between groups overall and in subsets of ZDV or combination therapy. The hazard ratio (HR) of a new class B event was 2.09 (95% CI 0.79-5.58) among women stopping ART, 1.24 (0.31-4.95) in those stopping ZDV, and 2.93 (0.64-13.36) among those stopping combination therapy. Women stopping ART had increased immune activation. No significant differences were seen in C-reactive protein, lipids, leptin, or interleukin-6.


CONCLUSIONS
While changes in CD4 and HIV RNA levels over one year were similar between women stopping or continuing ART postpartum, higher immune activation among women stopping therapy requires further study.
Watts
D H
DH
Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA. wattsh@mail.nih.gov
Lu
M
M
Thompson
B
B
Tuomala
R E
RE
Meyer
W A
WA
Mendez
H
H
Rich
K
K
Hanson
C
C
LaRussa
P
P
Diaz
C
C
Mofenson
L M
LM
D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000254:growth & development*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019562:Viral Load; D015215:Zidovudine / Q000008:administration & dosage
D044966:Anti-Retroviral Agents; D015415:Biomarkers; D012367:RNA, Viral; D015215:Zidovudine