5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 8–11 July 2003, Le Meridien Montparnasse, Paris, France

HIGH INCIDENCE OF PRE-ECLAMPSIA IN HIV-INFECTED PREGNANT WOMEN RECEIVING ANTIRETROVIRAL THERAPY

Antiviral Therapy 2003; 8:L19 (abstract 22)

A Suy, O Coll, M Lonca, E Martinez, A Milinkovic, JM Gatell and JA Vanrell
Hospital Clinic Universitari, Barcelona, Spain

BACKGROUND: Pre-eclampsia was an extremely rare entity in HIV-infected pregnant women until 2002. We have detected a high incidence of pre-eclampsia in HIV-infected pregnant women receiving antiretroviral therapy in 2002 and 2003. We studied the incidence of pre-eclampsia among HIV-infected women in our institution over time and we compared it with that of non-HIV-infected ones.

METHODS: Retrospective study of all pregnant women who delivered (at least 22 weeks of gestation) in our institution. HIV-infected women wishing to become pregnant are recommended to follow antiretroviral therapy according to current guidelines. HIV serology is routinely offered to all pregnant women unknown to be HIV-infected in Catalonia and antiretroviral therapy is provided to those who are HIV-infected according to current guidelines. Cases of pre-eclampsia (defined by hypertension and proteinuria) were identified from hospital files. Comparisons of the rates of preeclampsia and ante-partum mortality were done between HIV and non-HIV-infected patients.

RESULTS: Among 7720 women delivering at our institution, 71 (0.9%) were HIV-infected. There were 3112 deliveries and 3215 children born in 2001, 3634 and 3744 in 2002, and 974 and 1002 in the first quarter of 2003, respectively. Children born from HIV-infected mothers were 29 (0.9%) in 2001, 30 (0.8%) in 2002, and 12 (1.2%) in 2003. There were 32 (1%) women with preeclampsia in 2001, 51 (1.4%) in 2002, and 21 (2.1%) in 2003. None (0%) of the women with pre-eclampsia in 2001 was HIV-infected, but six (12%) were HIV-infected in 2002, and three (14%) in 2003. The risk of pre-eclampsia in HIV-infected women was 19-fold higher than in non-HIV-infected women in 2002–2003 (OR 19.5, 95% CI 8.3–44.6, P<0.0001). The ante-partum mortality was 22 women (none HIV-infected) in 2001, 24 (three HIV-infected), and seven (one HIV-infected) in 2003. Pre-eclampsia was the cause of death in all HIV-infected women. The risk of death in HIV-infected women was 17-fold higher than in non-HIV-infected women in 2002–2003 (OR 17.3, 95% CI 4.9–55.3, P<0.0001).

CONCLUSIONS: An unexpected high rate of pre-eclampsia has been identified in HIV-infected pregnant women in the past 2 years. If this trend is confirmed by other investigators, it may lead to change current recommendations on pregnancy in HIV-infected women. Studies of risk factors are under way.

Presenting author: A Suy

2003-07-08
22

Copyright © 2003 - International Medical Press Ltd.. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.