Women With Perinatal HIV Have Successful Pregnancies


SAN DIEGO — Women who acquire HIV perinatally have pregnancy outcomes that are on a par with those who acquire HIV later in life, results from a small single-center study suggest.

“This is a relatively new group of young mothers, and not much is known about how they do in pregnancy,” Dr. Tania Kasdaglis said in an interview during a poster session at the annual meeting of the Society for Maternal-Fetal Medicine. Many may assume “that perinatally infected HIV patients might have poorer pregnancy outcomes because they have had HIV longer or because their immune systems have been tried since they were born, but in fact they do very well.”

She and her colleagues in the department of obstetrics, gynecology, and reproductive sciences at the University of Maryland, Baltimore, studied women receiving prenatal care at the university's HIV clinic between 1997 and 2008. On a 1:1 basis they matched perinatally infected women with those who acquired the disease after childhood for age, race, and prepregnancy body mass index. Both groups had access to prenatal care, were on highly active antiretroviral therapy, had their CD4 counts and viral loads monitored, and were delivered at the university's medical center.

Among these women, 11 perinatally infected patients with 13 continuing pregnancies were studied. Cases were similar to controls in terms of mean age (18.7 years vs. 19 years), prepregnancy body mass index (27.7 kg/m2 vs. 27.3 kg/m2); third-trimester viral load (1,688 copies/mL vs. 10,548 copies/mL); third-trimester CD4 counts (391 vs. 410 cells/mcL); gestational age at delivery (38.3 weeks vs. 39 weeks), and birth weight percentile (32.1% vs. 39.4%). Although the viral load was not significantly different between the two groups, it was lower among perinatally infected women, suggesting that this group of women may be more compliant with highly active antiretroviral therapy (HAART) compared with controls, said Dr. Kasdaglis, a first-year maternal-fetal medicine fellow at the university.

The study findings show that “perinatally infected HIV patients have good pregnancy outcomes that do not differ from [those of] women who acquire HIV later in life and have access to the same level of prenatal care,” concluded Dr. Kasdaglis, who reported having no conflicts of interest.

'Perinatally infected HIV pregnant patients have good pregnancy outcomes' in this small study. DR. KASDAGLIS

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