Limited data exist on the use of acute-phase proteins as predictors of HIV-related outcomes. We examined the relationship between postpartum α(1)-acid glycoprotein (AGP) concentrations and HIV-related maternal mortality, mother-to-child transmission, and HIV-free survival among 643 Zimbabwean women. Elevated AGP was significantly associated with a 5.74-fold (p = 0.001) increased risk of maternal death, a 2.39-fold (p = 0.033) increased risk of postnatal transmission, and a marginally significant 1.85-fold (p = 0.087) increased risk of infant infection or death. In a resource-limited setting, AGP may be of utility as an inexpensive prognostic tool for HIV-infected individuals.