Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda英文文献资料.docVIP

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Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda英文文献资料.doc

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Associations between HIV Antiretroviral Therapy and the Prevalence and Incidence of Pregnancy in Rakai, Uganda英文文献资料

HindawiPublishingCorporation AIDSResearchandTreatment Volume2011,ArticleID519492,10pages doi:10.1155/2011/519492 ResearchArticle AssociationsbetweenHIVAntiretroviralTherapyand thePrevalenceandIncidenceofPregnancyinRakai,Uganda Fredrick. E. Makumbi,1,2 Gertrude Nakigozi, 2 Steven. J. Reynolds, Anthony Ndyanabo, 4 3 2 TomLutalo, 2 DavidSerwada, 1 FredNalugoda, 2 MariaWawer, andRonGray 4 1 2 3 4 SchoolofPublicHealth,MakerereUniversity,7072Kampala,Uganda RakaiHealthSciencesProgram,279Kalisizo,Uganda NationalInstituteofAllergyandInfectiousDiseases,NationalInstitutesofHealth,Bethesda,MD20892,USA SchoolofPublicHealth,JohnsHopkinsBloomberg,MD21205,USA CorrespondenceshouldbeaddressedtoFredrick.E.Makumbi,fmakumbi@ Received16June2010;Revised26October2010;Accepted12December2010 AcademicEditor:AnnDuerr Copyright?2011Fredrick.E.Makumbietal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Background.Useofantiretroviraltherapy(ART)maybeassociatedwithhigherpregnancyrates.Methods.Theprevalenceand incidenceofpregnancywasassessedin712HIV+pre-ARTwomenofreproductiveage(WRA)(15–45)and244HIV+WRA initiatingART.Prevalencerateratios(PRR),incidencerateratios(IRR),and95%con?denceinterval(CI)wereassessed.Results. Theincidenceofpregnancywas13.1/100pyamongwomeninpre-ARTcarecomparedto24.6/100pyamongwomenonART (IRR=0.54;95%CI0.37,0.81,p0.0017).TheprevalenceofpregnancyatARTinitiationwas12.0%withCD4counts100–250 comparedwith3.2%withCD4100(PRR=3.24,CI1.51–6.93),andtheincidenceofpregnancywhileonARTwashighestin womenwithagoodimmunologicresponse.Desireformorechildrenwasaveryimportantfactorinfertility.Conclusion.ARTwas associatedwithincreasedpregnancyratesinHIV+women,particularlythosewithhigherCD4countsandgoodimmunologic responsetotherapy,suggestinganeedtostrengthenreproductivehealthservicesforbothwomenandtheirpartnersthatcould addresstheirfertil