Objective: To determine the course and outcome of pregnancy in 54 persistently HIV-1-seronegative pregnant commercial sex workers (prostitutes).
Study design: Five hundred twenty-three initially HIV-1-seronegative prostitutes in Manipur, India, were studied between 1990 and 1999. Two hundred forty (46%) women seroconverted to HIV-1 during the study period. HIV-1 polymerase chain reaction with env, nef and vif gene primers was done on 98 persistently seronegative sex workers, who remained seronegative after three years of follow-up. Fifty-four of these women became pregnant (study group). The course and outcome of pregnancy were studied prospectively in 54 persistently HIV-1-seronegative women and compared with those in matched HIV-1-seronegative women from the general population coming for routine antenatal checkups.
Results: In the 54 seronegative women (study group) who became pregnant, there were 52 singleton, term vaginal deliveries and two emergency cesarean sections for fetal distress. All 54 infants had negative viral cultures for HIV-1 at birth. The women remained seronegative throughout pregnancy, as did the control group. All 54 infants were breast-fed and remained well.
Conclusion: A small proportion of highly exposed individuals may have natural protective immunity to HIV, may be resistant to HIV-1 and may have successful outcomes of pregnancy.