PREGNANCY MAY SLOW HIV PROGRESSION

Among HIV-infected women receiving HAART, pregnancy appears to reduce risk of progression to AIDS, and multiple pregnancies tend to reduce the risk even more, researchers report in the October 1st issue of the Journal of Infectious Diseases.

"This apparent dose-response relationship supports a possible protective effect of pregnancy on disease progression," senior investigator Dr. Timothy R. Sterling .

Dr. Sterling of Vanderbilt University School of Medicine, Nashville, Tennessee and colleagues assessed this relationship during the HAART era in an observational study of 759 women, of whom 541 (71%) had received HAART.

In all, 139 (18%) had at least 1 pregnancy and there was no difference in HAART duration by pregnancy status. The women were followed from 1997 to 2004.

During follow-up, 11 pregnant women (8%) and 129 non-pregnant women (24%) progressed to AIDS or death. After controlling for factors including baseline CD4+ lymphocyte counts and HIV-1 RNA levels, pregnancy was associated with reduced risk of progression (hazard ratio, 0.40).

Analysis of data on 81 pregnant women and 81 matched non-pregnant women showed that the pregnant group had a lower risk of progression both before pregnancy (hazard ratio, 0.10) and after the event (hazard ratio, 0.44).

The apparently protective effect of pregnancy, the researchers conclude, "could be the result of the healthier immune status of women who become pregnant or could possibly be related to a beneficial interaction between pregnancy and HAART."