Although the pregnant women in the study were younger than the non-pregnant women, had higher initial CD4+ lymphocyte counts (white blood cells that are attacked by HIV), and a smaller amount of HIV RNA in their plasma, their risk of disease progression remained lower even after factoring in these differences. Nor did it matter that the pregnant women also were more likely to receive HAART and more likely to attend clinic appointments.
Additionally, women with multiple pregnancies during follow-up tended to have a lower risk of disease progression than did women with only one pregnancy. Sterling notes, This apparent dose-response relationship supports a possible protective effect of pregnancy on disease progression. Pregnancy is associated with a complex set of immunological changes during the gestation period, which may provide additional benefit to the mothers health.
In an accompanying editorial, Kathryn Anastos, MD, of the Albert Einstein College of Medicine emphasized that although understanding of this complexity is not complete,
Dr. Sterlings study gives hope that correlative studies of the immune response to pregnancy and the influence of pregnancy on HIV disease may help to provide the needed information.
Dr. Anastos suggested that this information may be of particular significance to women in resource-limited communities, who generally bear more children than do those in higher-resource communities. She noted that women can now have greater confidence that in addition to protecting their children from [mother-to-child transmission of HIV] with HAART, their own health will not be compromised by pregnancy, which would place their children at long-term riskthe findings by Sterling and coworkers suggest that at least for HIV disease progression, the odds may be in their favor.
1) Women who became pregnant had a lower risk of HIV disease progression and w
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Infectious Diseases Society of America