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Prophylactic antiretroviral therapy has reduced to less than 1% the rate of HIV-infected babies born to HIV-positive mothers. We have substantial evidence about pregnancy outcomes in HIV-infected mothers but little about the mothers’ long-term clinical outcomes. In a prospective, observational study from Britain, researchers followed 311 HIV-infected pregnant women (85% black African) who delivered babies at six London hospitals from 1998 through 2002. Nearly all had acquired HIV infection through heterosexual intercourse; 85% were antiretroviral-naive at conception.
The women were each offered one of three HIV-management strategies, according to British HIV Association Guidelines: AZT monotherapy (AZTm) and prelabor cesarean section, based …