Is Pregnancy Associated with Biochemical and Haematological Changes in Hiv-Infected Nigerian Women?(Clinical Report‪)‬

The rate of HIV infection in pregnancy is high. (1-7) There is evidence that HIV infection in pregnant women is associated with adverse maternal and fetal outcomes. (2,5,6) The effects of HIV infection include severe anaemia, infectious morbidities and vertical transmission. (2,5,8-14) In a Malawian study, AIDS and anaemia were the leading causes of maternal mortality, (15) and in Zaire maternal mortality rates in HIV-infected women were 10 times those of HIV-negative women. (16) A personal communication revealed that in a recent unpublished report from a Nigerian Teaching Hospital, HIV/AIDS accounted for 20.2% of maternal deaths. However, the effect of pregnancy on HIV disease progression remains contentious. Evidence from developed countries suggests that pregnancy does not accelerate the progression of HIV disease, (17-21) while reports from low-resource settings imply otherwise, indicating that pregnancy may influence the rate of disease progression. (2) It has been suggested that other factors, including genetics, nutritional status and intercurrent infections, may be responsible for the rate of HIV disease progression in low-resource settings. (2,22,23) John and colleagues report an association between CCR5 pro-motor polymorphism and increased maternal mortality in a Kenyan cohort. (23)