Survival and disease progression in human immunodeficiency virus-infected women after an index delivery

Am J Obstet Gynecol. 1992 Jul;167(1):152-7. doi: 10.1016/s0002-9378(11)91650-0.

Abstract

Objective: Our objective was to provide information on survival and disease progression in human immunodeficiency virus antibody-positive pregnant women undergoing prospective evaluation.

Study design: After an index delivery, 103 human immunodeficiency virus antibody-positive pregnant women were identified and underwent follow-up for 3 years. The patients were assessed medically and/or gynecologically when hospitalized for a human immunodeficiency virus-related illness or at each follow-up visit. The life-table method was used to estimate the cumulative probabilities of survival and remaining free of acquired immunodeficiency syndrome. Cox's proportional-hazards analyses were used to identify prognostic factors for survival and progression to acquired immunodeficiency syndrome.

Results: The majority of human immunodeficiency virus-infected pregnant women were alive 3 years later. Lymphadenopathy syndrome or herpes genitalis was significantly associated with a subsequent diagnosis of acquired immunodeficiency syndrome. Of the 103 original patients, six had acquired immunodeficiency syndrome at the index delivery and acquired immunodeficiency syndrome developed in 24. Approximately 94% of evaluable patients with development of acquired immunodeficiency syndrome had CD4-lymphocyte counts < 200/mm3. The most common opportunistic infection was Pneumocystis carinii pneumonia. Acquired immunodeficiency syndrome and postpartum zidovudine therapy were independent prognostic factors affecting survival.

Conclusion: Survival was affected by Centers for Disease Control group status of human immunodeficiency virus infection at the index delivery.

MeSH terms

  • AIDS-Related Complex / mortality
  • AIDS-Related Opportunistic Infections
  • Acquired Immunodeficiency Syndrome / complications
  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / mortality*
  • CD4-Positive T-Lymphocytes
  • Candidiasis, Oral / complications
  • Female
  • HIV Seropositivity / mortality*
  • Humans
  • Leukocyte Count
  • Pregnancy
  • Pregnancy Complications, Infectious / mortality*
  • Prospective Studies
  • Survival Rate
  • Zidovudine / therapeutic use

Substances

  • Zidovudine