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. 2016 Mar;132(3):347-52.
doi: 10.1016/j.ijgo.2015.09.015. Epub 2015 Dec 31.

Effect of subsequent pregnancies on HIV disease progression among women in the Mulago Hospital MTCT-Plus program in Uganda

Dinah Amongin  1 , Annettee Nakimuli  1 , Robert Busingye  1 , Mike Mubiru  2 , Philippa Musoke  3 , Twaha Mutyaba  4
Affiliations

Effect of subsequent pregnancies on HIV disease progression among women in the Mulago Hospital MTCT-Plus program in Uganda

Dinah Amongin et al. Int J Gynaecol Obstet. 2016 Mar.

Abstract

Objective: To investigate the effect of subsequent pregnancies on HIV disease progression among HIV-infected women at Mulago Hospital, Uganda.

Methods: In a retrospective cohort study, data were analyzed from women enrolled in the Mother-To-Child Transmission Plus program from March 2003 to December 2011. The CD4 cell count, the development of new AIDS-defining opportunistic infections, and the AIDS-related mortality were compared between women with and without subsequent pregnancies.

Results: Overall, 409 women were enrolled and 195 (47.7%) had subsequent pregnancies. Antiretroviral therapy (ART) was initiated in 143 (73.3%) women with and 155 (72.4%) women without subsequent pregnancies. Kaplan-Meier analysis for women receiving ART showed no differences between women with and without subsequent pregnancies in the median times to clinical failure (62.7 vs 64.7 months; P=0.31), immunological failure (68.8 vs 75.5 months; P=0.10), and death (68.8 vs 75.5 months; P=0.53). In a Cox regression analysis, subsequent pregnancies were not associated with immunological failure during follow-up (adjusted hazard ratio 1.13, 95% confidence interval 0.06-2.09).

Conclusion: Subsequent pregnancies could have no detrimental effect on HIV disease progression among HIV-infected women whose treatment is well managed.

Keywords: HIV progression; Maternal mortality; Mulago; Subsequent pregnancies; Uganda; Women.

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Conflict of interest statement

Conflict of interest

The authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Patient flow chart Abbreviations: ADI, AIDS-defining illness; ART, antiretroviral therapy; MTCT-Plus, Mother-to-Child Transmission Plus program.
Fig. 2
Fig. 2
Kaplan–Meier analysis of time to clinical failure by pregnancy status Abbreviations: NoPreg, no subsequent pregnancies; SubPreg, subsequent pregnancies.
Fig. 3
Fig. 3
Kaplan–Meier analysis of time to immunological failure by pregnancy status. Abbreviations: NoPreg, no subsequent pregnancies; SubPreg, subsequent pregnancies.
Fig. 4
Fig. 4
CD4 cell count trends for HIV-infected women not receiving antiretroviral therapy by subsequent pregnancy status. Abbreviations: NoPreg, no subsequent pregnancies; SubPreg, subsequent pregnancies.
Fig. 5
Fig. 5
CD4 cell count trends for the study population overall stratified by pregnancy status. Abbreviations: NoPreg, no subsequent pregnancies; SubPreg, subsequent pregnancies.
See this image and copyright information in PMC

References

    1. Joint United Nations Programme on HIV/AIDS (UNAIDS) UNAIDS Report on the Global AIDS Epidemic 2010. Geneva: UNAIDS; 2010.
    1. Kisakye P, Akena WO, Kaye DK. Pregnancy decisions among HIV-Positive pregnant women in Mulago Hospital, Uganda. Cult Health Sex. 2010;12(4):445–54. - PubMed
    1. Myer L, Carter RJ, Katyal M, Toro P, El-Sadr WM, Abrams EJ. Impact of antiretroviral therapy on incidence of pregnancy among HIV-Infected women in Sub-Saharan Africa: A Cohort study. PLoS Med. 2010;7(2):1–10. - PMC - PubMed
    1. King R, Khana K, Nakayiwa S, Katuntu D, Homsy J, Lindkvist P, et al. ‘Pregnancy comes accidentally- like it did with me’: reproductive decisions among women on ART and their partners in rural Uganda. BMC Public Health. 2011;11:530. - PMC - PubMed
    1. Kakaire O, Osinde MO, Kaye DK. Factors that predict fertility desires for people living with HIV infection at a support and treatment centre in Kabale, Uganda. Reprod Health. 2010;7:27. - PMC - PubMed

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