Pregnancy outcomes in women with advanced HIV infection in Italy

Enrica Tamburrini, Carmela Pinnetti, S Baroncelli, M Ravizza, S Dalzero, M Scatà, A Crepaldi, G Liuzzi, Alessandra Molinari, A Vimercati, A Maccabruni, D Francisci, E Rubino, M. Floridia

Risultato della ricerca: Contributo in rivistaArticolo in rivista

12 Citazioni (Scopus)

Abstract

Pregnancy has been associated with a low risk of HIV disease progression. Most pregnancies with HIV currently involve women who have not experienced AIDS-defining events, and are clinically classified as Centers for Disease Control and Prevention (CDC) groups A or B. We evaluated the main maternal outcomes among pregnant women with more advanced HIV disease, defined by CDC-C disease stage. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. A total of 566 HIV-infected mothers, 515 in stage A or B (CDC-AB group) and 51 in stage C (CDC-C group) were evaluated. The two groups had similar baseline characteristics. No differences were found in the main maternal and neonatal outcomes. Most of the women achieved viral suppression at end of pregnancy (>1000 copies per milliliter: CDC-C: 17.2%; CDC-AB: 13.7%). One year after delivery, HIV replication (HIV-RNA >1000 copies per milliliter) was present in 11.5% of CDC-AB women and 30.0% CDC-C women. Despite lower initial CD4 counts (300 versus 481 cells per microliter), CDC-C women maintained stable CD4 levels during pregnancy, and 1 year after delivery, a significant increase in CD4 count from preconception values was observed in both groups (CDC-C: +72 cells per microliter, p=0.031; CDC-AB: +43 cells per microliter, p<0.001). Only one AIDS event occurred in a woman with a previous diagnosis of AIDS. In CDC-C women, pregnancy is not associated with an increased rate of adverse maternal or neonatal outcomes, and a good immunovirologic response can be expected. During postpartum care, women with more advanced HIV infection should receive particular care to prevent loss of virologic suppression.
Lingua originaleEnglish
pagine (da-a)639-645
Numero di pagine7
RivistaAIDS Patient Care and STDs
Volume25
DOI
Stato di pubblicazionePubblicato - 2011

Keywords

  • Adult
  • Anti-Retroviral Agents
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Disease Progression
  • Female
  • Gestational Age
  • HIV Infections
  • Humans
  • Italy
  • Logistic Models
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious
  • Pregnancy Outcome
  • Risk Factors
  • Severity of Illness Index
  • Viral Load
  • Young Adult

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