High Viral Load and Elevated Angiogenic Markers Associated With Increased Risk of Preeclampsia Among Women Initiating Highly Active Antiretroviral Therapy in Pregnancy in the Mma Bana Study, Botswana
Risk factors associated with preeclampsia in HIV-infected women remain largely unknown. Systemic angiogenic imbalance contributes to preeclampsia in HIV-uninfected women, but changes in angiogenic markers after highly active antiretroviral therapy (HAART) initiation have not been studied. The Mma Ba...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2013-04, Vol.62 (5), p.517-524 |
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| creator | POWIS, Kathleen M MCELRATH, Thomas F MACHAKAIRE, Esther LOCKMAN, Shahin ESSEX, Max SHAPIRO, Roger L HUGHES, Michael D OGWU, Anthony SOUDA, Sajini DATWYLER, Saul A VON WIDENFELT, Erik MOYO, Sikhulile NADAS, Marisa MAKHEMA, Joseph |
| description | Risk factors associated with preeclampsia in HIV-infected women remain largely unknown. Systemic angiogenic imbalance contributes to preeclampsia in HIV-uninfected women, but changes in angiogenic markers after highly active antiretroviral therapy (HAART) initiation have not been studied.
The Mma Bana study randomized 560 HIV-infected, HAART-naive pregnant women with CD4 counts ≥ 200 cells per cubic millimeter between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine or abacavir/zidovudine/lamivudine. Another 170 participants with CD4 counts less than 200 cells per cubic millimeter initiated nevirapine/zidovudine/lamivudine between 18 and 34 weeks gestation. Characteristics of 11 women who developed preeclampsia were compared with the remaining 722 Mma Bana participants who delivered using logistic regression. Plasma samples drawn at HAART initiation and 1 month later from 60 women without preeclampsia and at HAART initiation for all 11 preeclamptic women were assayed for placental growth factor (PlGF) and soluble FMS toll-like tyrosine kinase-1 (sFlt-1).
Pre-HAART viral load greater than 100,000 copies per milliliter was associated with preeclampsia (odds ratio: 5.8, 95% confidence interval: 1.8 to 19.4, P = 0.004). Median pre-HAART PlGF level was lower and sFlt-1 was higher in women who developed preeclampsia vs those who did not (130 vs 992 pg/mL, P = 0.001; 17.5 vs 9.4 pg/mL, P = 0.03, respectively). In multivariate analysis, PlGF and viral load remained significantly associated with preeclampsia. No significant changes in angiogenic factors were noted after 1 month of HAART treatment among non-preeclamptic women.
Pre-HAART viral load greater than 100,000 copies per milliliter and PlGF predicted preeclampsia among women starting HAART in pregnancy. Among non-preeclamptic women, HAART treatment did not significantly alter levels of PlGF or sFlt-1 after 1 month of treatment. |
| doi_str_mv | 10.1097/QAI.0b013e318286d77e |
| format | Article |
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The Mma Bana study randomized 560 HIV-infected, HAART-naive pregnant women with CD4 counts ≥ 200 cells per cubic millimeter between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine or abacavir/zidovudine/lamivudine. Another 170 participants with CD4 counts less than 200 cells per cubic millimeter initiated nevirapine/zidovudine/lamivudine between 18 and 34 weeks gestation. Characteristics of 11 women who developed preeclampsia were compared with the remaining 722 Mma Bana participants who delivered using logistic regression. Plasma samples drawn at HAART initiation and 1 month later from 60 women without preeclampsia and at HAART initiation for all 11 preeclamptic women were assayed for placental growth factor (PlGF) and soluble FMS toll-like tyrosine kinase-1 (sFlt-1).
Pre-HAART viral load greater than 100,000 copies per milliliter was associated with preeclampsia (odds ratio: 5.8, 95% confidence interval: 1.8 to 19.4, P = 0.004). Median pre-HAART PlGF level was lower and sFlt-1 was higher in women who developed preeclampsia vs those who did not (130 vs 992 pg/mL, P = 0.001; 17.5 vs 9.4 pg/mL, P = 0.03, respectively). In multivariate analysis, PlGF and viral load remained significantly associated with preeclampsia. No significant changes in angiogenic factors were noted after 1 month of HAART treatment among non-preeclamptic women.
Pre-HAART viral load greater than 100,000 copies per milliliter and PlGF predicted preeclampsia among women starting HAART in pregnancy. Among non-preeclamptic women, HAART treatment did not significantly alter levels of PlGF or sFlt-1 after 1 month of treatment.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e318286d77e</identifier><identifier>PMID: 23344545</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; Biomarkers ; Botswana ; Cohort Studies ; Drug therapy ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV Infections - blood ; HIV Infections - drug therapy ; HIV Infections - virology ; HIV-1 - growth & development ; HIV-1 - isolation & purification ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Logistic Models ; Medical sciences ; Microbiology ; Miscellaneous ; Placenta Growth Factor ; Pre-Eclampsia - blood ; Pre-Eclampsia - chemically induced ; Pre-Eclampsia - virology ; Preeclampsia ; Pregnancy ; Pregnancy Complications, Infectious - blood ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Complications, Infectious - virology ; Pregnancy Proteins - blood ; Risk factors ; Vascular Endothelial Growth Factor Receptor-1 - blood ; Viral diseases ; Viral Load ; Virology ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2013-04, Vol.62 (5), p.517-524</ispartof><rights>2014 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Apr 15, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-6ff8ef67c7ca5b200060c6922a7e57b3826169fa7f06b34f60d3ad557bfdbc563</citedby><cites>FETCH-LOGICAL-c499t-6ff8ef67c7ca5b200060c6922a7e57b3826169fa7f06b34f60d3ad557bfdbc563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27185723$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23344545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>POWIS, Kathleen M</creatorcontrib><creatorcontrib>MCELRATH, Thomas F</creatorcontrib><creatorcontrib>MACHAKAIRE, Esther</creatorcontrib><creatorcontrib>LOCKMAN, Shahin</creatorcontrib><creatorcontrib>ESSEX, Max</creatorcontrib><creatorcontrib>SHAPIRO, Roger L</creatorcontrib><creatorcontrib>HUGHES, Michael D</creatorcontrib><creatorcontrib>OGWU, Anthony</creatorcontrib><creatorcontrib>SOUDA, Sajini</creatorcontrib><creatorcontrib>DATWYLER, Saul A</creatorcontrib><creatorcontrib>VON WIDENFELT, Erik</creatorcontrib><creatorcontrib>MOYO, Sikhulile</creatorcontrib><creatorcontrib>NADAS, Marisa</creatorcontrib><creatorcontrib>MAKHEMA, Joseph</creatorcontrib><title>High Viral Load and Elevated Angiogenic Markers Associated With Increased Risk of Preeclampsia Among Women Initiating Highly Active Antiretroviral Therapy in Pregnancy in the Mma Bana Study, Botswana</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>Risk factors associated with preeclampsia in HIV-infected women remain largely unknown. Systemic angiogenic imbalance contributes to preeclampsia in HIV-uninfected women, but changes in angiogenic markers after highly active antiretroviral therapy (HAART) initiation have not been studied.
The Mma Bana study randomized 560 HIV-infected, HAART-naive pregnant women with CD4 counts ≥ 200 cells per cubic millimeter between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine or abacavir/zidovudine/lamivudine. Another 170 participants with CD4 counts less than 200 cells per cubic millimeter initiated nevirapine/zidovudine/lamivudine between 18 and 34 weeks gestation. Characteristics of 11 women who developed preeclampsia were compared with the remaining 722 Mma Bana participants who delivered using logistic regression. Plasma samples drawn at HAART initiation and 1 month later from 60 women without preeclampsia and at HAART initiation for all 11 preeclamptic women were assayed for placental growth factor (PlGF) and soluble FMS toll-like tyrosine kinase-1 (sFlt-1).
Pre-HAART viral load greater than 100,000 copies per milliliter was associated with preeclampsia (odds ratio: 5.8, 95% confidence interval: 1.8 to 19.4, P = 0.004). Median pre-HAART PlGF level was lower and sFlt-1 was higher in women who developed preeclampsia vs those who did not (130 vs 992 pg/mL, P = 0.001; 17.5 vs 9.4 pg/mL, P = 0.03, respectively). In multivariate analysis, PlGF and viral load remained significantly associated with preeclampsia. No significant changes in angiogenic factors were noted after 1 month of HAART treatment among non-preeclamptic women.
Pre-HAART viral load greater than 100,000 copies per milliliter and PlGF predicted preeclampsia among women starting HAART in pregnancy. Among non-preeclamptic women, HAART treatment did not significantly alter levels of PlGF or sFlt-1 after 1 month of treatment.</description><subject>Adult</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Botswana</subject><subject>Cohort Studies</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>HIV</subject><subject>HIV Infections - blood</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - growth & development</subject><subject>HIV-1 - isolation & purification</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Placenta Growth Factor</subject><subject>Pre-Eclampsia - blood</subject><subject>Pre-Eclampsia - chemically induced</subject><subject>Pre-Eclampsia - virology</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - blood</subject><subject>Pregnancy Complications, Infectious - drug therapy</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Pregnancy Proteins - blood</subject><subject>Risk factors</subject><subject>Vascular Endothelial Growth Factor Receptor-1 - blood</subject><subject>Viral diseases</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkt1u1DAQhSMEoqXwBghZQkhckGInjp3cIKVVoSttxV-hl9HEmWTdJvZiexftE_JaeLdLgV7Z4_nmzFhzkuQ5o8eMVvLt53p2TFvKcsxZmZWikxIfJIes4jyVZckfxnuRFSlneXGQPPH-mlImOK8eJwdZnnNe8OIw-XWuhwX5rh2MZG6hI2A6cjbiGgJ2pDaDtgMarcgFuBt0ntTeW6V32SsdFmRmlEPwMfyi_Q2xPfnkENUI09JrIPVkzUCu7IQmojrESh0ftl3HDalV0GuMbYJ2GJxd7-a4XKCD5YZos9UaDBi1C8ICycUE5AQMkK9h1W3ekBMb_M8YP00e9TB6fLY_j5Jv788uT8_T-ccPs9N6nipeVSEVfV9iL6SSCoo2o5QKqkSVZSCxkG1eZoKJqgfZU9HmvBe0y6ErYqrvWlWI_Ch5d6u7XLUTdgpNiCM3S6cncJvGgm7-zxi9aAa7bnJR5nFtUeD1XsDZHyv0oZm0VziOYNCufBO3lWWllNm218t76LVdORO_FykmGYuKWaT4LaWc9d5hfzcMo83WKU10SnPfKbHsxb8fuSv6Y40IvNoD4BWMvYtr0P4vJ1lZyEj_Bos1y08</recordid><startdate>20130415</startdate><enddate>20130415</enddate><creator>POWIS, Kathleen M</creator><creator>MCELRATH, Thomas F</creator><creator>MACHAKAIRE, Esther</creator><creator>LOCKMAN, Shahin</creator><creator>ESSEX, Max</creator><creator>SHAPIRO, Roger L</creator><creator>HUGHES, Michael D</creator><creator>OGWU, Anthony</creator><creator>SOUDA, Sajini</creator><creator>DATWYLER, Saul A</creator><creator>VON WIDENFELT, Erik</creator><creator>MOYO, Sikhulile</creator><creator>NADAS, Marisa</creator><creator>MAKHEMA, Joseph</creator><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7U1</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>20130415</creationdate><title>High Viral Load and Elevated Angiogenic Markers Associated With Increased Risk of Preeclampsia Among Women Initiating Highly Active Antiretroviral Therapy in Pregnancy in the Mma Bana Study, Botswana</title><author>POWIS, Kathleen M ; MCELRATH, Thomas F ; MACHAKAIRE, Esther ; LOCKMAN, Shahin ; ESSEX, Max ; SHAPIRO, Roger L ; HUGHES, Michael D ; OGWU, Anthony ; SOUDA, Sajini ; DATWYLER, Saul A ; VON WIDENFELT, Erik ; MOYO, Sikhulile ; NADAS, Marisa ; MAKHEMA, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-6ff8ef67c7ca5b200060c6922a7e57b3826169fa7f06b34f60d3ad557bfdbc563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Botswana</topic><topic>Cohort Studies</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. 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Systemic angiogenic imbalance contributes to preeclampsia in HIV-uninfected women, but changes in angiogenic markers after highly active antiretroviral therapy (HAART) initiation have not been studied.
The Mma Bana study randomized 560 HIV-infected, HAART-naive pregnant women with CD4 counts ≥ 200 cells per cubic millimeter between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine or abacavir/zidovudine/lamivudine. Another 170 participants with CD4 counts less than 200 cells per cubic millimeter initiated nevirapine/zidovudine/lamivudine between 18 and 34 weeks gestation. Characteristics of 11 women who developed preeclampsia were compared with the remaining 722 Mma Bana participants who delivered using logistic regression. Plasma samples drawn at HAART initiation and 1 month later from 60 women without preeclampsia and at HAART initiation for all 11 preeclamptic women were assayed for placental growth factor (PlGF) and soluble FMS toll-like tyrosine kinase-1 (sFlt-1).
Pre-HAART viral load greater than 100,000 copies per milliliter was associated with preeclampsia (odds ratio: 5.8, 95% confidence interval: 1.8 to 19.4, P = 0.004). Median pre-HAART PlGF level was lower and sFlt-1 was higher in women who developed preeclampsia vs those who did not (130 vs 992 pg/mL, P = 0.001; 17.5 vs 9.4 pg/mL, P = 0.03, respectively). In multivariate analysis, PlGF and viral load remained significantly associated with preeclampsia. No significant changes in angiogenic factors were noted after 1 month of HAART treatment among non-preeclamptic women.
Pre-HAART viral load greater than 100,000 copies per milliliter and PlGF predicted preeclampsia among women starting HAART in pregnancy. Among non-preeclamptic women, HAART treatment did not significantly alter levels of PlGF or sFlt-1 after 1 month of treatment.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>23344545</pmid><doi>10.1097/QAI.0b013e318286d77e</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1525-4135 |
| ispartof | Journal of acquired immune deficiency syndromes (1999), 2013-04, Vol.62 (5), p.517-524 |
| issn | 1525-4135 1944-7884 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3683097 |
| source | Freely Accessible Journals; MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete |
| subjects | Adult Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences Biomarkers Botswana Cohort Studies Drug therapy Female Fundamental and applied biological sciences. Psychology HIV HIV Infections - blood HIV Infections - drug therapy HIV Infections - virology HIV-1 - growth & development HIV-1 - isolation & purification Human immunodeficiency virus Human viral diseases Humans Infectious diseases Logistic Models Medical sciences Microbiology Miscellaneous Placenta Growth Factor Pre-Eclampsia - blood Pre-Eclampsia - chemically induced Pre-Eclampsia - virology Preeclampsia Pregnancy Pregnancy Complications, Infectious - blood Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - virology Pregnancy Proteins - blood Risk factors Vascular Endothelial Growth Factor Receptor-1 - blood Viral diseases Viral Load Virology Young Adult |
| title | High Viral Load and Elevated Angiogenic Markers Associated With Increased Risk of Preeclampsia Among Women Initiating Highly Active Antiretroviral Therapy in Pregnancy in the Mma Bana Study, Botswana |
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