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Researchers are calling for enhanced healthcare for HIV-infected mothers after they give birth, following a study showing that in the two-year period after birth, mothers with HIV have a high incidence of infectious diseases.

The study findings were published this week (1 October) in the Journal of Acquired Immune Deficiency Syndromes.

"Women bear the brunt of the HIV epidemic, constituting 60 per cent of all HIV infected people globally, and yet few studies have been conducted to understand HIV in women," Dorothy Mbori-Ngacha, one of the study researchers from the Department of Paediatrics at the University of Nairobi, Kenya, told SciDev.Net.

Five hundred and thirty-five women were enrolled in the study group in Nairobi. Upper respiratory tract infection was the most common illness (161 incidents for every 100 women in the first year of follow-up), followed by diarrhoea (62 per 100 women), pneumonia (33 per 100 women) and tuberculosis (11 per 100 women).

Ngacha said these figures are much higher than one would expect in postpartum women without HIV.

Previous studies have shown that pregnant and postpartum women have a weakened immune system, which can result in an increased number of infections.

The study revealed that women with low immunity and high HIV loads were more likely to suffer from opportunistic infections, such as pneumonia, oral thrush and tuberculosis.

Less than ten per cent of women in the study reported hospitalisation during the two-year follow-up, and death rates were 1.9 per cent and 4.8 per cent at one and two years, respectively.

"Translated to practice, this points to the fact that with optimum care and follow-up, women can have good health outcomes," said Ngacha.

The study authors suggest that much of the illness in HIV-infected postpartum women could be prevented by modifying 'prevention of mother-to-child transmission' programmes — which focus on preventing HIV transmission to infants — so they pay more attention to the health of the mother.

Most women of childbearing age in Sub-Saharan Africa, according to the study, are generally healthy and it is only in the context of HIV that the burden of illness increases.

Link to abstract in the Journal of Acquired Immune Deficiency Syndromes

Reference: Journal of Acquired Immune Deficiency Syndromes 46, 208 (2007)

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