Systemic inflammation in pregnant women with HIV : relationship with HIV treatment regimen and preterm delivery
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc..
OBJECTIVE: : HIV treatment regimen during pregnancy was associated with preterm delivery (PTD) in the PROMISE 1077 BF trial. Systemic inflammation among pregnant women with HIV could help explain differences in PTD by treatment regimen. We assessed associations between inflammation, treatment regimen, and PTD.
DESIGN/METHODS: : A nested 1:1 case-control study (N = 362) was conducted within a multi-country randomized trial comparing three HIV regimens in pregnant women: zidovudine alone, or combination antiretroviral therapy (ART) with lopinavir/ritonavir and either zidovudine or tenofovir. Cases were women with PTD (<37 weeks of gestational age). The following inflammatory biomarkers were measured in plasma samples using immunoassays: soluble CD14 (sCD14) and sCD163, intestinal fatty acid-binding protein, interleukin (IL)-6, interferon γ, and tumor necrosis factor α. We fit regression models to assess associations between second trimester biomarkers (measured before ART initiation at 13-23 weeks of gestational age and 4 weeks later), treatment regimen, and PTD. We also assessed whether inflammation was a mediator in the relationship between ART regimen and PTD.
RESULTS: : Persistently high interleukin-6 was associated with increased PTD. Compared to zidovudine alone, the difference in biomarker concentration between week 0 and week 4 was significantly higher (p < 0.05) for both PI-based regimens. However, the estimated proportion of the ART effect on increased PTD mediated by persistently high biomarker levels was ≤5% for all biomarkers.
CONCLUSIONS: : Persistently high IL-6 during pregnancy was associated with PTD. While PI-based ART was associated with increases in inflammation, factors other than inflammation likely explain the increased PTD in ART-based regimens compared to zidovudine alone.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
AIDS (London, England) - (2024) vom: 26. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shivakoti, Rupak [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 19.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1097/QAD.0000000000003877 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369015592 |
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| 100 | 1 | |a Shivakoti, Rupak |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Systemic inflammation in pregnant women with HIV |b relationship with HIV treatment regimen and preterm delivery |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a OBJECTIVE: : HIV treatment regimen during pregnancy was associated with preterm delivery (PTD) in the PROMISE 1077 BF trial. Systemic inflammation among pregnant women with HIV could help explain differences in PTD by treatment regimen. We assessed associations between inflammation, treatment regimen, and PTD | ||
| 520 | |a DESIGN/METHODS: : A nested 1:1 case-control study (N = 362) was conducted within a multi-country randomized trial comparing three HIV regimens in pregnant women: zidovudine alone, or combination antiretroviral therapy (ART) with lopinavir/ritonavir and either zidovudine or tenofovir. Cases were women with PTD (<37 weeks of gestational age). The following inflammatory biomarkers were measured in plasma samples using immunoassays: soluble CD14 (sCD14) and sCD163, intestinal fatty acid-binding protein, interleukin (IL)-6, interferon γ, and tumor necrosis factor α. We fit regression models to assess associations between second trimester biomarkers (measured before ART initiation at 13-23 weeks of gestational age and 4 weeks later), treatment regimen, and PTD. We also assessed whether inflammation was a mediator in the relationship between ART regimen and PTD | ||
| 520 | |a RESULTS: : Persistently high interleukin-6 was associated with increased PTD. Compared to zidovudine alone, the difference in biomarker concentration between week 0 and week 4 was significantly higher (p < 0.05) for both PI-based regimens. However, the estimated proportion of the ART effect on increased PTD mediated by persistently high biomarker levels was ≤5% for all biomarkers | ||
| 520 | |a CONCLUSIONS: : Persistently high IL-6 during pregnancy was associated with PTD. While PI-based ART was associated with increases in inflammation, factors other than inflammation likely explain the increased PTD in ART-based regimens compared to zidovudine alone | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Giganti, Mark J |e verfasserin |4 aut | |
| 700 | 1 | |a Lederman, Michael M |e verfasserin |4 aut | |
| 700 | 1 | |a Ketchum, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Brummel, Sean |e verfasserin |4 aut | |
| 700 | 1 | |a Moisi, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Dadabhai, Sufia |e verfasserin |4 aut | |
| 700 | 1 | |a Moodley, Dhayendre |e verfasserin |4 aut | |
| 700 | 1 | |a Violari, Avy |e verfasserin |4 aut | |
| 700 | 1 | |a Chinula, Lameck |e verfasserin |4 aut | |
| 700 | 1 | |a Owor, Maxensia |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Amita |e verfasserin |4 aut | |
| 700 | 1 | |a Currier, Judith S |e verfasserin |4 aut | |
| 700 | 1 | |a Taha, Taha E |e verfasserin |4 aut | |
| 700 | 1 | |a Fowler, Mary Glenn |e verfasserin |4 aut | |
| 700 | 0 | |a PROMISE study team |e verfasserin |4 aut | |
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