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首页> 外文期刊>AIDS >Women's morbidity and mortality in the first 2 years after delivery according to HIV status.
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Women's morbidity and mortality in the first 2 years after delivery according to HIV status.

机译：分娩后头两年根据艾滋病毒状况分列的妇女发病率和死亡率。

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BACKGROUND: Better knowledge of the impact of HIV status on morbidity and mortality patterns of women after delivery is important to improve clinical and policy recommendations. METHODS: Women were enrolled during pregnancy in the Vertical Transmission Study, prior to antiretroviral roll-out in South Africa, and followed for 24 months after delivery. Their health was evaluated by standardized questionnaires and clinical examinations. RESULTS: Information was available for 2624 women, 50.5% of whom were HIV-infected. Mortality was 8.6 deaths per 1000 person-years in HIV-uninfected, and 55.68 in HIV-infected women. Mortality was associated with antenatal CD4 cell count in HIV-infected women: 171.43/1000 person-years in those with CD4 cell count below 200 compared to 19.35/1000 in those with CD4 cell count at least 200. There was no significant difference between the intensity of breastfeeding during the first 3 months after delivery in women who died and those who survived, regardless of mother's HIV infection status (P = 0.112 and P = 0.530, respectively). Serious morbidity events were documented in 250 of 2624 (9.5%) women; the most common events were bloody diarrhoea (26.4%), pulmonary tuberculosis (24.4%) and an abscess (17.2%). Multivariable Cox regression analysis identified HIV infection, lower levels of education, river/stream water source as risk factors. CONCLUSION: HIV-infected women experienced more morbidity and mortality than HIV-uninfected women; this was predicted by maternal immune status and socio-economic factors. HIV-infected women even in the high CD4 strata had higher mortality than HIV-uninfected women from the same population. This study underlines the importance of interventions to improve maternal health, for example timely antiretroviral treatment, tuberculosis screening, and improved water and sanitation.
机译：背景：更好地了解艾滋病毒状况对分娩后妇女的发病率和死亡率的影响，对于改善临床和政策建议很重要。方法：在垂直传播研究中，孕妇在怀孕期间入组，然后在南非进行抗逆转录病毒治疗，然后分娩后进行了24个月的随访。他们的健康状况通过标准化的问卷调查和临床检查进行了评估。结果：有2624名妇女可获得信息，其中50.5％的妇女感染了HIV。未感染艾滋病毒的死亡率为每1000人年8.6例死亡，而感染HIV的妇女为55.68例。死亡率与HIV感染妇女的产前CD4细胞计数有关：CD4细胞计数低于200的女性为171.43 / 1000人年，而CD4细胞计数至少为200的女性为19.35 / 1000。无论母亲的艾滋病毒感染状况如何，无论死去还是幸存的妇女，分娩后头三个月的母乳喂养强度（分别为P = 0.112和P = 0.530）。 2624名妇女中有250名（9.5％）记录了严重的发病率事件;最常见的事件是血性腹泻（26.4％），肺结核（24.4％）和脓肿（17.2％）。多变量Cox回归分析确定了HIV感染，较低的教育水平，河流/溪流水源是危险因素。结论：感染艾滋病毒的妇女发病率和死亡率要高于未感染艾滋病毒的妇女。这是由产妇的免疫状况和社会经济因素预测的。甚至在高CD4阶层中受HIV感染的妇女，其死亡率也高于同一人群中未受HIV感染的妇女。这项研究强调了干预措施对改善产妇健康的重要性，例如及时进行抗逆转录病毒治疗，结核病筛查以及改善饮水和卫生条件。

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