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. 2008 Nov;9(10):897-900.
doi: 10.1111/j.1468-1293.2008.00641.x. Epub 2008 Sep 14.

Pregnancy may be followed by an inflexion of the immune reconstitution in HIV-infected women who receive antiretroviral drugs before conception

V Le Moing  1 , A Taïeb, P Longuet, C Lewden, V Delcey, M C Thiebaut Drobacheff, G Chêne, C Leport; ANRS CO8 (APROCO-COPILOTE) study group
Collaborators, Affiliations

Pregnancy may be followed by an inflexion of the immune reconstitution in HIV-infected women who receive antiretroviral drugs before conception

V Le Moing et al. HIV Med. 2008 Nov.

Abstract

Background: Whether pregnancy has an impact on the evolution of CD4 cell counts in women treated with highly potent antiretrovirals before conception remains largely unknown.

Methods: Among patients enrolled in the ANRS CO8 (APROCO/COPILOTE) cohort, we selected all women aged between 18 and 50 years at initiation of combination antiretroviral therapy (cART). Slopes of CD4 cell counts during follow-up were estimated using mixed longitudinal models with time-dependent indicators for pregnancy and delivery.

Results: Of the 260 selected HIV-infected women, a pregnancy occurred in 39 women in a median follow-up time of 66 months. Women who became pregnant had higher CD4 cell count at baseline but this difference progressively lessened during follow-up because they had a slower increase than women who did not become pregnant. The estimated slope of CD4 cell count decreased significantly from +2.3 cells/muL/month before pregnancy and in women who did not become pregnant to -0.04 cells/microL/month after delivery (P=0.0003).

Conclusion: A significant increase in CD4 cell count may be preferable before pregnancy in women treated with cART, in order to overcome the evolution observed after pregnancy.

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Figures

Figure 1
Figure 1
Mean CD4+ cell counts during follow-up according to the occurrence of a pregnancy in 260 women aged 18–50 at enrollment in ANRS CO8 (APROCO/COPILOTE) cohort study.
See this image and copyright information in PMC

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