Universal antiretroviral therapy among pregnant and postpartum HIV-infected women would improve maternal health and decrease postnatal HIV transmission.

摘要

In a recent issue of AIDS, the Zvitambo study group from Zimbabwe showed increased postpartum mortality among HIV-infected women with a high CD4 cell count who were not eligible for and not receiving antiretroviral therapy (ART), compared to HlV-uninfected postpartum women from the same population [1]. In the 2 years postpartum, the adjusted mortality hazard ratio (95% confidence interval) was 7.3 (3.6-15.1) among HIV-infected women with baseline CD4 cell count between 600 and 800 cells/ml, compared to the reference category of HIV-uninfected women [1]. The authors therefore argued the case for early ART initiation among all pregnant and postpartum women in Africa, irrespective of CD4 cell count or treatment eligibility. We entirely agree with this interpretation of their findings, in particular because such a strategy would also contribute to the elimination of paediatric HIV in breastfeeding populations.