Effect of subsequent pregnancies on HIV disease progression among women in the Mulago Hospital MTCT-Plus program in Uganda.

Autor: Amongin D; Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda., Nakimuli A; Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda., Busingye R; Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda., Mubiru M; Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda., Musoke P; Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda; Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Mutyaba T; Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: tmutyaba@yahoo.com.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2016 Mar; Vol. 132 (3), pp. 347-52. Date of Electronic Publication: 2015 Dec 31.
DOI: 10.1016/j.ijgo.2015.09.015
Abstrakt: Objective: To investigate the effect of subsequent pregnancies on HIV disease progression among HIV-infected women at Mulago Hospital, Uganda.
Methods: In a retrospective cohort study, data were analyzed from women enrolled in the Mother-To-Child Transmission Plus program from March 2003 to December 2011. The CD4 cell count, the development of new AIDS-defining opportunistic infections, and the AIDS-related mortality were compared between women with and without subsequent pregnancies.
Results: Overall, 409 women were enrolled and 195 (47.7%) had subsequent pregnancies. Antiretroviral therapy (ART) was initiated in 143 (73.3%) women with and 155 (72.4%) women without subsequent pregnancies. Kaplan-Meier analysis for women receiving ART showed no differences between women with and without subsequent pregnancies in the median times to clinical failure (62.7 vs 64.7 months; P=0.31), immunological failure (68.8 vs 75.5 months; P=0.10), and death (68.8 vs 75.5 months; P=0.53). In a Cox regression analysis, subsequent pregnancies were not associated with immunological failure during follow-up (adjusted hazard ratio 1.13, 95% confidence interval 0.06-2.09).
Conclusion: Subsequent pregnancies could have no detrimental effect on HIV disease progression among HIV-infected women whose treatment is well managed.
(Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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