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Infectious Diseases in Obstetrics and Gynecology
Volume 2009 (2009), Article ID 456717, 8 pages
Research Article

Treatment Interruption after Pregnancy: Effects on Disease Progression and Laboratory Findings

1Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
2Clinical Trials and Surveys Corp., Owings Mills, MD 21117, USA
3Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
4Quest Diagnostics, Baltimore, MD 21227, USA
5Department of Pediatrics, State University of New York Downstate, Brooklyn, NY 11203, USA
6Department of Pediatrics, University of Illinois, Chicago, IL 60612, USA
7Department of Pediatrics, Baylor University, Houston, TX 77030, USA
8Department of Pediatrics, Columbia University, New York, NY 10032, USA
9Department of Pediatrics, University of Puerto Rico, San Juan, PR 00936, USA

Received 15 June 2009; Accepted 25 August 2009

Academic Editor: Susan Cu-Uvin

Copyright © 2009 D. H. Watts et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To assess clinical progression and inflammatory markers among women stopping or continuing antiretroviral therapy (ART) after pregnancy. Methods. ART-naïve women with CD4+ lymphocyte counts >350 cells/uL initiating ART during pregnancy had clinical events and laboratory markers compared over one year postpartum between those stopping ( ) or continuing ( ) ART. Results. Slopes in CD4 count and HIV RNA did not differ between groups overall and in subsets of ZDV or combination therapy. The hazard ratio (HR) of a new class B event was 2.09 (95% CI 0.79–5.58) among women stopping ART, 1.24 (0.31–4.95) in those stopping ZDV, and 2.93 (0.64–13.36) among those stopping combination therapy. Women stopping ART had increased immune activation. No significant differences were seen in C-reactive protein, lipids, leptin, or interleukin-6. Conclusions. While changes in CD4 and HIV RNA levels over one year were similar between women stopping or continuing ART postpartum, higher immune activation among women stopping therapy requires further study.