Levy JW, Kaseba CM, Matongo I, Mulenga H, Stringer JS, Stringer EM; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. ThPeC7313.
Center for Infectious Disease Research in Zambia, Lusaka, Zambia
Background: The natural history of HIV infection in a postpartum breastfeeding population in Zambia is not well described. Methods: As part of a contraceptive clinical trial in Lusaka, Zambia, we prospectively followed HIV-infected women and their infants for up to two years postpartum. Women were enrolled at 6-8 weeks postpartum and those with clinical AIDS were excluded. All women received single-dose NVP for perinatal prophylaxis, but none received antiretroviral treatment of their disease. Maternal deaths were evaluated by verbal autopsy. Results: 599 HIV-infected women were enrolled, 361 had reached the 6 month follow-up and 143 women had reached the one year follow-up at time of analysis. 559 of 599 (93%) of women were breastfeeding. The mean BMI at enrollment was 24.2 (SD 23.9-24.6). The mean CD4 count at the time of enrollment was 505 cells/mm3 (SD 486-531). 58 women (9.8%) had CD4 less than 200 at enrollment, but no evidence of clinical AIDS. The mean change in BMI over one year was.07 (p=ns). The mean decrease in CD4 count over 1 year was 92 cells/mm3 (95% CI: 70 -116). 11 maternal deaths had occurred at time of analysis. Women who died had lower enrollment CD4 counts than did survivors, 225 vs. 510 (p<0.001). Verbal autopsy revealed that 5 of 11 (45%) deaths were definitely AIDS related and the remaining 6 were probably AIDS related. At the time of analysis, 41 (6.8%) children had died. Among women with surviving infants, mean CD4 at enrollment was significantly higher than that in women whose infants had died (514 v. 386; p=0.002.) Infant infection status evaluation is ongoing. Conclusions: This interim analysis of postpartum women in Zambia suggests high death rates among the women and their offspring and underscores the urgent need for family antiretroviral therapy.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Breast Feeding
- CD4 Lymphocyte Count
- Child
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Infant
- Postpartum Period
- Pregnancy
- Zambia
Other ID:
UI: 102281093
From Meeting Abstracts