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September 14, 2007

Pregnancy Protective Against HIV Disease Progression

New data published in the October 1 issue of the Journal of Infectious Diseases reveal that pregnancy may actually have protective health effects for HIV-positive women. The study found that HIV-positive pregnant women were more than 60 percent less likely to progress to AIDS or death than those who did not become pregnant.

The study’s principal author, Jennifer Tai, MD, of the Vanderbilt University School of Medicine, and her colleagues followed 759 HIV-positive women between January 1997 and December 2004. A total of 540 women received antiretroviral treatment. During the course of the study, 139 women of the 759 studied became pregnant. The researchers found that only 11 (8 percent) of the women who became pregnant developed AIDS or died, compared with 149 (24 percent) of those who did not become pregnant. Because the group of pregnant women were more likely to have certain characteristics, such as higher CD4 cell counts and better adherence to antiretroviral therapy, researchers performed a second analysis. Even after controlling for such factors, the study concluded that pregnant women remained far less likely to progress to AIDS.

This study is the first to evaluate disease progression in pregnant women since the introduction of highly active antiretroviral therapy (HAART) and should give some comfort to HIV-positive women who are pregnant or want to have children. In an accompanying editorial, Kathy Anastos, MD, a physician at Montefiore Medical Center in the Bronx, NY, sums up the results of the study nicely and writes, “For all women, pregnancy is something of a gamble: there is no guarantee of a normal pregnancy or a healthy baby. For HIV-infected women becoming pregnant, the findings of [this study] suggest that, at least for HIV disease progression, the odds may be in their favor.”

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