Study warns HIV+ women on births
Posted by African Press International on September 20, 2007
By Kakaire A. Kirunda
HIV positive women determined to have children should be informed about the potential negative effects of pregnancy on their body’s ability to fight diseases and should be offered contraception.
“Such women should be informed that it is likely to be safer to have a pregnancy in the early clinical stage of HIV infection, when CD4 counts are still relatively high, so that the steeper CD4 decline after pregnancy is less likely to result in progression to clinically manifest disease and death,” the study says.
The study that was done in South Western Uganda investigated the effect of pregnancy on HIV progression and survival among infected women in rural Uganda, prior to the introduction of anti-retroviral therapy (ART).
HIV progression is measured using a CD4 count, which tells the strength of one’s immune system, how far the disease has advanced, and helps predict the risk of complications and debilitating infections. The procedure is most useful when it is compared with the count obtained from an earlier test.
“In resource poor settings with restricted availability of ART, women who are pregnant and eligible for ART should be offered such treatment as a priority group since they are at high risk for fast progression and as ART will at the same time protect the baby from HIV infection,” says the study.
It was done by the Entebbe based Medical Research Council and the Uganda Virus Research Institute. The findings are published in the August edition of the Tropical Medicine and International Health journal. The researchers also suggest that it might be advisable for women on ART with low CD4 counts and are determined to have children, to postpone a pregnancy until CD4 counts have increased.
Led by Mr Lieve Van der Paal, the scientists selected records of 139 HIV-infected women of reproductive age from a clinical group established in 1990. Women who subsequently became pregnant had higher CD4 counts at enrolment and had a slower CD4 decline than those who didn’t become pregnant. In those who became pregnant, CD4 decline was faster after pregnancy than before. But the researchers concluded, “The initial comparative immunological advantage possessed by fertile women before they become pregnant is subsequently lost as a result of their pregnancy.”
Another significant finding of the study was that since the introduction of the prevention of mother-to-child transmission programme in the South Western region in 2002, only very few HIV-positive women (less than 5 per cent in the study area) have opted not to breastfeed their newborn babies.
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