Brief Report: Consequences of Presentation With Advanced HIV Disease in Pregnancy: Data From a National Study in Italy.
Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity.
*Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy; †Department of Infectious Diseases, Catholic University, Rome, Italy; ‡Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and Universiy of Turin, Turin, Italy; §Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy; ‖Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy; ¶Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy; #Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy; **Department of Obstetrics and Gynaecology, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy; ††INMI Lazzaro Spallanzani, Rome, Italy; ‡‡Department of Obstetrics and Gynaecology, City Hospital, Prato, Italy; and §§Operative Unit of Infectious Disease, Hospital of Macerata, Macerata, Italy.
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Tamburrini
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Giovanni
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Molinari
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Serena
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Arsenio
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Giuseppina
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Liuzzi
Carmela
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Pinnetti
Ilaria
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Vicini
Paula
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Castelli
Valentina
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D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D057210:Delayed Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007558:Italy / Q000453:epidemiology; D008297:Male; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D055815:Young Adult