Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa

Background. High maternal body mass index (BMI) and the timing of antiretroviral (ART) initiation in pregnant women living with human immunodeficiency virus (HIV) (WLWH) may affect the controlled systemic inflammation during pregnancy. Proinflammatory immune markers during pregnancy and the impact of maternal BMI in WLWH initiating ART in pregnancy or preconception will be evaluated. Methods. In this mini-dissertation is a protocol (Part A), journal formatted manuscript (Part B) and Appendices (Part C) for a study on maternal BMI and inflammation in WLWH. A subset cohort from the Prematurity Immunology in HIV-infected Mothers and their infants Study (PIMS) study had three plasma immune markers (c-reactive protein (CRP), interferon-gamma inducible protein-10 (IP-10) and serum amyloid A (SAA)) and maternal weight measured from April 2015 to October 2016, at four antenatal care visits (visit 1, 2 (two weeks post-ART initiation in those initiating in pregnancy), 3 and 4). The association with maternal BMI by ART initiation (on ART preconception or initiated during current pregnancy) was assessed. Results. Among 526 pregnant WLWH, those on preconception ART had CRP and IP-10 levels lower compared to those who initiated ART in pregnancy. CRP was higher in obese WLWH (irrespective of timing of ART initiation) than those with a normal or overweight BMI. IP-10 was elevated in the 2nd trimester and SAA levels were highest in WLWH with a normal BMI. Conclusion. Immune marker level elevation is dependent on timing of ART exposure and pregnancy trimester. The timing of ART initiation and maternal BMI may adversely impact systemic inflammation in pregnant WLWH.

Grantor

Department of Public Health and Family Medicine

Year dc:date.issued

2023

Author dc:creator

• More, Jessica

Advisor dc:contributor.advisor

• Malaba, Thokozile

• Epidemiology and Biostatistics

Handle dc:identifier.uri

http://hdl.handle.net/11427/39706

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/39706