Mortality among HIV-positive postpartum women with high CD4 cell counts in Zimbabwe

AIDS. 2010 Jan 28;24(3):F11-4. doi: 10.1097/qad.0b013e328335749d.

Abstract

Background: Whereas HAART initiated at CD4 cell counts 351-450 cells/ml reduces mortality, compared with starting at lower CD4 levels, there is currently no evidence for the advantages of initiating treatment at CD4 cell counts greater than 450 cells/ml.

Methods: Mortality hazard, as a function of CD4 cell count, was estimated among postpartum HIV-positive women in Zimbabwe, using HIV-negative women as the reference group.

Results: Mortality within 24 months postpartum was 54 times higher among women with CD4 cell counts less than 200 cells/ml, fell to 5.4 times higher for those with CD4 cell counts 400-600 cells/ml but fell little thereafter. For CD4 cell counts greater than 600 cells/ml the hazard was 6.2 (95% confidence interval 3.2-11.9).

Conclusion: Early HAART initiation for all HIV-positive pregnant women may benefit individual mothers and infants, and simultaneously reduce population HIV incidence.

Trial registration: ClinicalTrials.gov NCT00198718.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count / statistics & numerical data
  • Female
  • HIV Seropositivity / drug therapy
  • HIV Seropositivity / immunology
  • HIV Seropositivity / mortality*
  • HIV-1 / immunology*
  • Humans
  • Postpartum Period*
  • Pregnancy
  • Prognosis
  • RNA, Viral
  • Viral Load
  • Zimbabwe / epidemiology

Substances

  • RNA, Viral

Associated data

  • ClinicalTrials.gov/NCT00198718