DOES PREGNANCY INFLUENCE THE COURSE OF HIV-INFECTION - EVIDENCE FROM 2 LARGE SWISS COHORT STUDIES

The question whether the natural history of HIV infection in women is affected by pregnancy has not so far been convincingly answered. We us ed prospective cohort data to compare pregnant and nonpregnant HIV-inf ected women during follow-up within the Swiss HIV Cohort Study (SHCS) and the Swiss Collaborative HIV and Pregnancy Study (SCHPS). Pregnant women were eligible if a CD4 cell count had been made before conceptio n had taken place. Additional inclusion criteria were a pregnancy comp leted to delivery during follow-up and an observation period of at lea st 6 months after delivery. Thirty-two women who fulfilled these crite ria were compared with 416 controls, matched for age and CD4 cell coun t at entry, who had not been pregnant during follow-up. Mean follow-up time was 4.8 years for pregnant women and 3.6 years for controls. The rare of any AIDS-defining event was higher in pregnant women (rate ra tio [RR] from Cox regression, 1.92: 95% confidence interval [CI], 0.80 -4.64) but this did not reach statistical significance (p = .15). A st atistically significant difference (p = .008) emerged only for one AID S-defining event, recurrent bacterial pneumonia (RR, 7.98: 95% CI, 1.7 3-36.8). The rate of death was similar in the two groups (RR, 1.14; 95 % CI, 0.48-2.72; p = .8), Our results thus indicate that, after taking CD4 cell counts before conception into account, acceleration of disea se progression is inconsistent among HN-infected women who become preg nant during follow-up.