Pregnancy For HIV-Positive Women Safer In Early Stages
HIV-positive women who want to become pregnant should be informed thatpregnancy is safer during the early clinical stages of the virus, whenCD4+ T cell counts are higher, according to a study published recentlyin Tropical Medicine & International Health, Uganda's Monitor reports.
LieveVan der Paal of Uganda's Medical Research Council and colleagues fromthe Uganda Virus Research Institute examined the medical records of 139HIV-positive women of reproductive age residing in southwestern Ugandawho were in a clinical group established in 1990. The researchersexamined the effect of pregnancy on HIV progression and survival amongHIV-positive women before the introduction of antiretroviral drugs.
Thestudy found that women who became pregnant had higher CD4 counts whenthey enrolled in the study and that they had a slower decline of CD4cells than those who did not become pregnant. The study also found thatCD4 counts declined faster after pregnancy. The researchers concludedthat the "initial comparative immunological advantage possessed byfertile women before they become pregnant is subsequently lost as aresult of their pregnancy." The researchers suggested that women takingantiretrovirals who have low CD4 counts wait until their CD4 countshave increased before becoming pregnant.
According to the study,HIV-positive women who want to become pregnant should be warned aboutthe potential negative effect a pregnancy could have on their immunesystem's ability to fight HIV and should be offered contraception.Pregnant women living with HIV who are eligible for antiretroviraltherapy "should be offered such treatment as a priority group sincethey are at high risk for fast progression" of HIV and because theantiretrovirals will help prevent mother-to-child HIV transmission, thestudy said. The study also found that since the introduction of aprogram aimed at preventing mother-to-child transmission, less than 5%of HIV-positive mothers in southwest Uganda do not breast-feed(Kirunda, Monitor, 9/17).
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