Dinah Amongin1, Annettee Nakimuli1, Robert Busingye1, Mike Mubiru2, Philippa Musoke3, Twaha Mutyaba4. 1. Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda. 2. Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda. 3. 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. 4. Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: tmutyaba@yahoo.com.
Abstract
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.
OBJECTIVE: To investigate the effect of subsequent pregnancies on HIV disease progression among HIV-infectedwomen 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-infectedwomen whose treatment is well managed.
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