Natural history of HIV-1 infection in African women: a prospective cohort study in Kigali (Rwanda), 1988-1991. NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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Natural history of HIV-1 infection in African women: a prospective cohort study in Kigali (Rwanda), 1988-1991.

Int Conf AIDS. 1992 Jul 19-24;8(1):Mo11 (abstract no. MoC 0035). Unique Identifier : AIDSLINE ICA8/92399991
Msellati P; Leroy V; Lepage P; Hitimana DG; Mukamabano B; Van Goethem C; Van de Perre P; Dabis F; INSERM U. 330, Bordeaux, France.

Abstract: OBJECTIVES: 1) To evaluate prospectively morbidity and mortality in a cohort of HIV-1 infected women. 2) To compare these features with those of a cohort of HIV-uninfected women. METHODS: In the context of a study on perinatal transmission of HIV-1, we enrolled at delivery 215 HIV seropositive (HIV+) and 216 HIV seronegative (HIV-) women of same age and parity. They were systematically examined at 3 month intervals during the first 24 months of follow-up. The clinical examination focused on the signs and symptoms included in the WHO clinical case definition for AIDS in adults. The numbers of hospitalizations, medical injections and disease related out-of-work days were obtained. At delivery, a blood sample was collected for HIV antibodies (ELISA and Western Blot) and syphilis testing (VDRL and TPHA). T4 and T8 lymphocyte count was done at 15 days post-partum. HIV- women who seroconverted during the follow-up have been excluded from the analysis since the date of seroconversion. RESULTS: At inclusion, none of the HIV+ women fulfilled the clinical definition of AIDS. However, 72.4% of HIV+ women (N = 185) versus 10.1% of HIV- women had a T4/T8 ratio less than 1.0 (p less than 0.001). There was no statistical difference between the two groups of women for the presence of syphilis serological markers (16% among HIV+ and 10% among HIV- women; p = 0.16). During the follow-up, there was no difference between the two groups for the occurrence of symptoms and signs except generalized lymphadenopathy (GL). Incidence of GL was 53 per 100 women-years (WY) in the HIV+ group versus 31 in the HIV- group (p less than or equal to 0.01). Among HIV+ women, the incidence of tuberculosis was 1.2 per 100 WY of follow-up versus 0.3 among HIV- women (Relative risk: 4.2; 95% Confidence Interval [CI]: 2.8-5.6). No significant difference was observed between HIV+ and HIV- women for the numbers of hospitalizations, injections and out-of-work days. Among HIV+ women, the incidence of AIDS was 1.5 per 100 WY (5 cases) and the mortality rate was 3.7 per 100 WY (12 deaths). One death was reported among HIV- women. CONCLUSION: GL and tuberculosis were the most common features of HIV infection in this cohort of women. Among these HIV+ women of childbearing age, who were asymptomatic at inclusion, the mortality was high even if full blown AIDS rarely occurred.
Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY AIDS-Related Complex/EPIDEMIOLOGY Cohort Studies Comparative Study Female Human HIV Infections/CONGENITAL/COMPLICATIONS/*EPIDEMIOLOGY/ TRANSMISSION HIV Seropositivity/EPIDEMIOLOGY *HIV-1 Incidence Infant, Newborn Pregnancy Pregnancy Complications, Infectious/*EPIDEMIOLOGY Prospective Studies Rwanda/EPIDEMIOLOGY Survival Rate Tuberculosis/EPIDEMIOLOGY ABSTRACTKWDacquiredimmunodeficiencysyndrome/epidemiologyaids-relatedcomplex/epidemiologycohortstudiescomparativestudyfemalehumanhivinfections/congenital/complications/KWDepidemiology/transmissionhivseropositivity/epidemiologyKWDhiv-1incidenceinfant,newbornpregnancypregnancycomplications,infectious/KWDepidemiologyprospectivestudiesrwanda/epidemiologysurvivalratetuberculosis/epidemiologyabstract
921230
M92C5356

Copyright © 1992 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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