Survival and disease progression in human immunodeficiency virus-infected women after an index delivery

Objective: Our objective was to provide information on survival and disease progression in human immunodeficiency virus antibody—positive pregnant women undergoing prospective evaluation. Study design: After an index delivery, 103 human immunodeficiency virus antibody—positive pregnant women were identified and underwent follow-up for 3 years. The patients were assessed medically and/or gynecologically when hospitalized for a human immunodeficiency virus—related illness or at each follow-up visit. The life-table method was used to estimate the cumulative probabilities of survival and remaining free of acquired immunodeficiency syndrome. Cox's proportional-hazards analyses were used to identify prognostic factors for survival and progression to acquired immunodeficiency syndrome. Results: The majority of human immunodeficiency virus—infected pregnant women were alive 3 years later. Lymphadenopathy syndrome or herpes genitalis was significantly associated with a subsequent diagnosis of acquired immunodeficiency syndrome. Of the 103 original patients, six had acquired immunodeficiency syndrome at the index delivery and acquired immunodeficiency syndrome developed in 24. Approximately 94% of evaluable patients with development of acquired immunodeficiency syndrome had CD4-lymphocyte counts <200/mm³. The most common opportunistic infection was Pneumocystis carinii pneumonia. Acquired immunodeficiency syndrome and postpartum zidovudine therapy were independent prognostic factors affecting survival. Conclusions: Survival was affected by Centers for Disease Control group status of human immunodeficiency virus infection at the index delivery.