Document 2404
 DOCN  M94A2404
 TI    The role of pregnancy/puerperium in tuberculosis development in
       HIV-infected women.
 DT    9412
 AU    Espinal M; Reingold AL; CENISMI, Santo Domingo, Dominican Rep.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):311 (abstract no. PC0174). Unique
       Identifier : AIDSLINE ICA10/94370171
 AB    OBJECTIVE: To determine the effect of pregnancy/puerperium on the risk
       of Tuberculosis (TB) in HIV-infected and uninfected women of
       reproductive age. METHODS: An ongoing case-control study in women 15-44
       years of age in Santo Domingo, the Dominican Republic. Women with newly
       diagnosed TB who are tested for HIV infection in four hospitals, and
       women without TB who test HIV-positive and HIV-negative, in a testing
       center, are invited to participate. The subjects are interviewed to
       collect data on their reproductive history (number and timing of
       pregnancies and their outcome, breast-feeding history, etc) and other
       characteristics. The student t-test, Chi-square, and the Mantel-Haenszel
       stratified analysis for adjusted odds ratios (OR) and 95% confidence
       intervals (95% CI) are used. RESULTS: 577 women have been enrolled, 405
       with TB; and 172 without TB (86 HIV-positive and 86 HIV-negative). HIV
       seroprevalence in women with TB is 5.9% (95% CI: 3.8%, 8.7%). Recent
       pregnancy (< 6 months) appeared to have a strong protective effect on
       the risk of developing active TB in both HIV (+) and (-) women: HIV (+)
       women with TB vs HIV (-) women with TB (OR: 0.24, 95% CI: 0.06, 0.78);
       HIV (+) women with TB vs HIV (+) women without TB (OR: 0.20, 95% CI:
       0.04, 0.84); HIV (-) women with TB vs HIV (-) women without TB (OR:
       0.78, 95% CI: 0.47, 1.29). The risk of active TB within 6 months of
       childbirth, adjusted for HIV infection was 0.63 (95% CI: 0.41, 0.96).
       CONCLUSIONS: These data suggest that recently ended pregnancy is
       associated with a lower risk of TB, regardless of HIV status, but that
       HIV infection modifies the effect of pregnancy on the risk of active TB.
       This effect among HIV (+) women may be due to an effect of HIV-induced
       immunosuppression that simultaneously increases the risk of TB and
       decreases fertility or the ability to carry a pregnancy to term.
 DE    Adolescence  Adult  Female  Human  HIV Infections/*COMPLICATIONS  HIV
       Seropositivity  Pregnancy  *Pregnancy Complications, Infectious
       *Reproductive History  Risk Factors  Tuberculosis/*COMPLICATIONS
       MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).