CD4 Changes in HAART-Naive HIV Positive Pregnant Women on HAART: Low Resource Setting Experience

PURPOSE: PMTCT interventions, especially initiation of Highly active antiretroviral therapy (HAART) has modified the natural history of HIV infection by reducing both peripartal and neonatal HIV infections, but the pattern of the immunologic responses of these pregnant women to HAART remains speculative. It is hoped from this study, to describe the pattern of immunologic response of na ve, HIV positive pregnant women on their first initiation on HAART. METHODS: This study described the pattern of CD4 changes observed in freshly diagnosed 126 HIV positive pregnant women, stratified into the trimesters of pregnancy and commenced on HAART (Zidovudine, Lamivudine and Nevirapine) for a period of 2 months in pregnancy. CD4 counts were determined at point of recruitment and monthly thereafter using a Parteccytometer counter (Cyflow(R)). Neonatal outcome was also described. RESULTS: Our findings suggest better immunologic response and fewer neonatal infectionsin group of na ve women initiated on HAART while in the first 26 weeks of pregnancy and lesser response in those commenced in the third trimester of pregnancy. CONCLUSION: Concerted efforts should be directed towards the initiation of HAART prophylaxis before end of 2nd trimester of pregnancy.