Before the advent of highly active antiretroviral therapy (HAART), many women with HIV infection or AIDS were told that becoming pregnant would be unwise because there was thought to be a 25 percent risk of transmitting the virus to the child and that the effects of pregnancy on disease progression were unclear. It is now clear that the use of HAART in pregnancy can reduce the HIV transmission to the newborn to approximately one percent, but the effects of pregnancy on the HIV-infected woman remain unknown.

To determine the effects of pregnancy on HIV disease progression, Timothy R. Sterling, MD, and colleagues at Vanderbilt University performed an observational study. Disease progression was defined as experiencing an AIDS-defining event such as Kaposi’s sarcoma, Pneumocystis carinii pneumonia, or Candida fungal infection of the esophagus or death. Of the 759 women studied, 71 percent (540) were receiving HAART. Eighteen percent (139) of women studied had one or more pregnancy during this study.

Sterling and colleagues found that women who became pregnant actually had a lower risk of HIV disease progression and were healthier than women who did not become pregnant. Women experienced a lower risk of disease progression both before and after pregnancy. This may be a result of the healthier immune status of women who become pregnant and/or a beneficial interaction between pregnancy and HAART.

Additionally, women with multiple pregnancies during follow-up tended to have a lower risk of disease progression than did women with only one pregnancy. Sterling notes, “This apparent dose-response relationship supports a possible protective effect of pregnancy on disease progression. Pregnancy is associated with a complex set of immunological changes during the gestation period, which may provide additional benefit to the mother’s health.”; Source: Infectious Diseases Society of America