Title: Effect of pregnancy on HIV disease progression and survival among women in rural Uganda.

POPLINE Document Number: 313771

Author(s):

Van der Paal L
Shafer LA
Mayanja BN
Whitworth JA
Grosskurth H

Source citation:

Tropical Medicine and International Health, 2007 Aug;12(8):920-928.

Abstract:

The objective was to investigate the effect of pregnancy on HIV disease progression and survival among HIV-infected women in rural Uganda, prior to the introduction of anti-retroviral therapy (ART). From a clinical cohort established in 1990, we selected records from HIV-infected women of reproductive age. We conducted two analyses: (1) all HIV-infected cases contributing to analysis of CD4 decline, using a linear regression model with random intercepts and slopes; (b) incident cases with known date of seroconversion contributed to analyses of median time to CD4 less than 200 cells/microl, AIDS and death. A total of 139 women were included in the analysis of CD4 decline. Women who subsequently became pregnant had higher CD4 counts at enrolment and had a slower CD4 decline than those who did not become pregnant. In women who became pregnant, CD4 decline was faster after pregnancy than before (P less than 0.0001). The survival analyses showed no significant differences between women who became pregnant and those who did not with respect to median time to CD4 count less than 200, AIDS or death. The initial comparative immunological advantage possessed by fertile women before they become pregnant is subsequently lost as a result of their pregnancy. Women should be informed about the potential negative effect of pregnancy on their immunological status and should be offered contraception. In resource-limited settings, women determined to become pregnant should be given priority for ART if eligible. (author's)

Keywords:

Uganda
Research Report
Cohort Analysis
Clinical Trials
Linear Regression
Women
Persons Living With HIV/AIDS
Rural Population
HIV
AIDS
Pregnancy
Immunological Effects
Immunologic Factors
Risk Factors
Developing Countries
Africa, Eastern
Africa, Sub Saharan
Africa
Research Methodology
Clinical Research
Statistical Regression
Data Analysis
Demographic Factors
Population
HIV Infections
Viral Diseases
Diseases
Population Characteristics
Reproduction
Immunity
Immune System
Physiology
Biology