Is the prevalence of pre-eclampsia affected by HIV/AIDS? A retrospective case-control study : cardiovascular topics

Abstract

ObjectiveTo evaluate the rate of HIV/AIDS (and CD4 levels) in women with pre-eclampsia compared to that of a control group.MethodsThis was a retrospective case–control study in a tertiary and regional hospital in South Africa. We reviewed the hospital records of women who had delivered in these hospitals between 1 January 2008 and 30 June 2010. The records of women with pre-eclampsia during the study period were analysed. Their HIV infection rate was compared to that of a control group consisting of normotensive healthy pregnant women.ResultsAmong 492 cases of pre-eclampsia, 130 (26.4%) were HIV infected. In the control group, 183/500 (36.6%) were HIV infected (p = 0.001, OR = 0.62, 95% CI: 0.47–0.82). After adjustment to match the difference in maternal age and parity, the rate of HIV/AIDS was lower in the pre-eclamptic group than in the control group (p = 0.005, OR = 0.658).ConclusionThe rate of HIV/AIDS was significantly lower in women with pre-eclampsia than in normotensive healthy pregnant women.

Hypertension, preeclampsia and eclampsia among HIV-infected pregnant women from Latin America and Caribbean countries

“…when compared to uninfected women or HIV-infected on treatment. More recently, Kalumba et al 34 described a lower rate of HIV-infection among women with pre-eclampsia when compared with women without pre-eclampsia. Several studies show no difference in the rates of PE between HIV-uninfected and HIV-infected women treated with HAART 35,36 or even a lower rate of PE among HIV-infected treated when compared to uninfected women 10 .…”

Pro-Inflammatory Cytokine Levels in HIV Infected and Uninfected Pregnant Women with and without Preeclampsia

“…There is no consensus on the relationship between these conditions since data on the impact of HIV on the rate of PE are conflicting [8]. HAART may influence the postulated effect of HIV on the development of hypertensive disorders during pregnancy [9].…”

The role of trophoblast cell receptor expression in HIV‐1 passage across the placenta in pre‐eclampsia: an observational study

“…ICAM‐2, a marker of inflammation, had a significantly higher expression in placental tissue of HIV‐negative pre‐eclamptic women than the other groups. Our findings of differences in inflammatory marker expression in normotensive and pre‐eclamptic HIV‐positive patients corroborate evidence that HAART treatment possibly improves immunity, which restores or exacerbates the risk of developing pre‐eclampsia …”

“…As HIV‐infected mothers receive ARV, it is plausible that these drugs are maintaining the expression of ICAM‐2 comparable to those of the HIV uninfected normotensive group. This could be a result of HIV infection of the placenta reducing expression levels to evade leucocyte attack, suggesting a mechanism for the protective effect of HIV infection against pre‐eclampsia . It also lends credence to reports suggesting that patients receiving HAART have an increased risk of pre‐eclampsia which may be due to immune reconstitution.…”

“…There is controversy as to whether HIV infection has an impact on the frequency of pre‐eclampsia. It has been reported that the rate of HIV is significantly lower in pre‐eclampsia than in normotensive pregnancies and that this is based on an immune mechanism . Such altered immune states will impact on the expression of receptors and cytokines on placental tissue implicated in vertical transmission of HIV.…”