Four years of natural history of HIV-1 infection in african women: a prospective cohort study in Kigali (Rwanda) , 1988-1993
Leroy, V.; Msellati, P.; Lepage, P.; Batungwanayo, J.; Hitimana, D.G.; Taelman, H.; Bogaerts, J.; Boineau, F.; Van de Perre, P.; Simonon, A.
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology Official Publication of the International Retrovirology Association 9(4): 415-421
1995
ISSN/ISBN: 1077-9450 PMID: 7600110 Document Number: 325503
Clinical features and mortality due to human immunodeficiency virus type-I (HIV-1) infection in women are described as part of a prospective 4-year cohort study on perinatal transmission of HIV in Kigali, Rwanda. Two hundred fifteen HIV-seropositive (HIV+) and 216 HIV-seronegative (HIV-) pregnant women were enrolled at delivery between November 1988 and June 1989. Clinical information collected during systematic quarterly examinations was compared. HIV antibody tests were performed at delivery and CD4/CD8 lymphocyte counts at 15 days' postpartum. HIV- women who seroconverted during the follow-up period were excluded from the analysis of the comparison group starting at the date of seroconversion. At enrollment, all HIV+ women were asymptomatic for acquired immune deficiency syndrome (AIDS). Incidence of tuberculosis was 2.9 per 100 women-years (WY) after 4 years of follow-up in HIV+ women versus 0.2 per 100 WY among HIV- women (relative risk, 18.2; 95% confidence interval 2.4-137.0). Among HIV+ women, the incidence of AIDS (World Health Organization clinical AIDS definition) was 3.5 per 100 WY. The mortality rate was 4.4 per 100 WY among HIV+ women versus 0.5 per 100 WY among HIV- women. Clinical AIDS was present in only half of the fatalities. Tuberculosis was a major cause of morbidity and mortality in these HIV+ African women. An early diagnosis and an appropriate treatment or prevention of tuberculosis should improve the quality of life of HIV-infected patients in Africa.