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M94A2404.TXT
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1994-10-25
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Document 2404
DOCN M94A2404
TI The role of pregnancy/puerperium in tuberculosis development in
HIV-infected women.
DT 9412
AU Espinal M; Reingold AL; CENISMI, Santo Domingo, Dominican Rep.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):311 (abstract no. PC0174). Unique
Identifier : AIDSLINE ICA10/94370171
AB OBJECTIVE: To determine the effect of pregnancy/puerperium on the risk
of Tuberculosis (TB) in HIV-infected and uninfected women of
reproductive age. METHODS: An ongoing case-control study in women 15-44
years of age in Santo Domingo, the Dominican Republic. Women with newly
diagnosed TB who are tested for HIV infection in four hospitals, and
women without TB who test HIV-positive and HIV-negative, in a testing
center, are invited to participate. The subjects are interviewed to
collect data on their reproductive history (number and timing of
pregnancies and their outcome, breast-feeding history, etc) and other
characteristics. The student t-test, Chi-square, and the Mantel-Haenszel
stratified analysis for adjusted odds ratios (OR) and 95% confidence
intervals (95% CI) are used. RESULTS: 577 women have been enrolled, 405
with TB; and 172 without TB (86 HIV-positive and 86 HIV-negative). HIV
seroprevalence in women with TB is 5.9% (95% CI: 3.8%, 8.7%). Recent
pregnancy (< 6 months) appeared to have a strong protective effect on
the risk of developing active TB in both HIV (+) and (-) women: HIV (+)
women with TB vs HIV (-) women with TB (OR: 0.24, 95% CI: 0.06, 0.78);
HIV (+) women with TB vs HIV (+) women without TB (OR: 0.20, 95% CI:
0.04, 0.84); HIV (-) women with TB vs HIV (-) women without TB (OR:
0.78, 95% CI: 0.47, 1.29). The risk of active TB within 6 months of
childbirth, adjusted for HIV infection was 0.63 (95% CI: 0.41, 0.96).
CONCLUSIONS: These data suggest that recently ended pregnancy is
associated with a lower risk of TB, regardless of HIV status, but that
HIV infection modifies the effect of pregnancy on the risk of active TB.
This effect among HIV (+) women may be due to an effect of HIV-induced
immunosuppression that simultaneously increases the risk of TB and
decreases fertility or the ability to carry a pregnancy to term.
DE Adolescence Adult Female Human HIV Infections/*COMPLICATIONS HIV
Seropositivity Pregnancy *Pregnancy Complications, Infectious
*Reproductive History Risk Factors Tuberculosis/*COMPLICATIONS
MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).