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Brief Report: Consequences of Presentation With Advanced HIV Disease in Pregnancy: Data From a National Study in
Marco Floridia1, Enrica Tamburrini, Giulia Masuelli
1*Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy; †Department of Infectious Diseases, Catholic University, Rome, Italy; ‡Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and Universiy of Turin, Turin, Italy; §Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy; ‖Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy; ¶Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy; #Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy; **Department of Obstetrics and Gynaecology, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy; ††INMI Lazzaro Spallanzani, Rome, Italy; ‡‡Department of Obstetrics and Gynaecology, City Hospital, Prato, Italy; and §§Operative Unit of Infectious Disease, Hospital of Macerata, Macerata, Italy.
Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity.
Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity.
