Term Pregnancy Women with Human Immunodeficiency Virus Infection Receiving Antiretroviral Threapy as A Risk Factor for Low Expression of Mitochondiral Deoxyribose-Nucleic Acid in Placenta

Abstract

Antiretroviral therapy (ART) given to pregnant women with Human Immunodeficiency Virus (HIV) has the effect of mitochondrial DNA (mtDNA) depletion through several steps, either directly or indirectly. This decrease may trigger the occurrence of reactive oxygen species (ROS) and mitochondrial toxicity which are characterized by energy insufficiency, cell dysfunction, and maternal and placental apoptosis. This study aimed to determine whether term pregnant women with HIV infection receiving antiretroviral therapy are risk factors for low mtDNA expression in the placenta. This cross-sectional analytic study was conducted at Sanglah Hospital Denpasar and affiliation hospitals. Inclusion samples were termed pregnant women with HIV (+) who received ART ≥ 6 months as a risk group and pregnant women with HIV (-) as a non-risk group. Expression of mtDNA was assessed by real-time Polymerase Chain Reaction (rtPCR) examination of placental samples. The estimated relative amount of mtDNA was calculated by dividing the number of mtDNA to the number of nDNA, as a reference. The cut-off value of mtDNA expression was determined by plotting a Receiver Operating Characteristics (ROC) curve. The results of the analysis found that pregnant women with HIV who received ART≥6 months had a prevalence of low mtDNA expression by 2.83 times higher than pregnant women without HIV (95% confidence interval = 1.42 – 5.67; p-value = 0.000). The conclusion of this study is that term pregnant women with HIV infection who receive ART is a risk factor for low mtRNA expression in the placental.