Pregnancy linked to a lower risk of progression of HIV infection

Since the advent of HAART, pregnancy is associated with a lower risk of progression of HIV infection, according to a U.S. study published in the Journal of Infectious Diseases.

Published before the appearance of highly active antiretroviral therapy (HAART) in 1996, several studies have examined the risk of progression of infection in pregnant women, with very different results.

According to some, the pregnancy and had no impact, while others showed the contrary a slight increase in risk, remember Jennifer Tai, of Vanderbilt University School of Medicine in Nashville (Tennessee), and colleagues.

After examining 759 women living with HIV, 139 became pregnant at least once between 1997 and 2004, the researchers found, during this period, a decrease in the risk of progression in the past, between 53% and 60%.

After limiting their study on a group of 81 pregnant women, compared to 81 women who were not, they showed that the risk of death decreased by 72% in the study group, while the risk of classifying events AIDS, despite a downward trend (-45%) was not significantly different between the two groups.

The potentially positive effect of pregnancy was found in women with CD4 counts intermediaries between 200 and 500 cells/mm3.

The researchers also note that the risk of progression was even lower among women who had two pregnancies than among those not having had one (84%).

Although this figure does not reach statistical significance, this potential "dose-response relationship supports the hypothesis of a protective effect of pregnancy in terms of progression."

Recalling that this effect was not observed prior to 1996, the researchers suggest that "a beneficial interaction between pregnancy and HAART may explain the more favorable outcome of women with children."

Among the possible mechanisms, the researchers suggest changes in immune order that occur during pregnancy, such as the transition of T lymphocytes h1 deviation (Th1 promoting cellular immunity) to those types of h2 (Th2 involved in the production of antibodies).