Trial reportJournal of acquired immune deficiency syndromes (1999)2013
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.
Trial report in Journal of acquired immune deficiency syndromes (1999), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Systematic and meta-analysis of factors associated with preeclampsia and eclampsia in sub-Saharan Africa.PloS one · 2020Pooled it
- Combined antiretroviral therapy for HIV and the risk of hypertensive disorders of pregnancy: A systematic review.Pregnancy hypertension · 2019Pooled it
- Antiretroviral Therapy at Conception Leads to Lower Peripheral CD49aJournal of immunology research · 2025Article
- High sensitivity C-reactive protein in pre-eclamptic women living with HIV at a tertiary hospital in Zambia: a preliminary study.The Pan African medical journal · 2024Article
- Determinants and neonatal outcomes of preeclampsia among women living with and without HIV at a tertiary hospital in Zambia: a review of medical records.The Pan African medical journal · 2022Review
- HIV Associated Preeclampsia: A Multifactorial Appraisal.International journal of molecular sciences · 2021Review
- A Narrative Review of the Renin-Angiotensin-Aldosterone System in the Placenta and Placental Bed of HIV Infected Women of African Ancestry with Preeclampsia.Current hypertension reports · 2021Review
- Maternal endothelial dysfunction in HIV-associated preeclampsia comorbid with COVID-19: a review.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Review
- Vascular mechanisms and molecular targets in hypertensive pregnancy and preeclampsia.American journal of physiology. Heart and circulatory physiology · 2020Review
- No association between early antiretroviral therapy during pregnancy and plasma levels of angiogenic factors: a cohort study.BMC pregnancy and childbirth · 2019Article
- Angiogenesis, Lymphangiogenesis, and the Immune Response in South African Preeclamptic Women Receiving HAART.International journal of molecular sciences · 2019Review
- Antigen Analysis of Pre-Eclamptic Plasma Antibodies UsingMolecular & cellular proteomics : MCP · 2018Article
- HIV antiretroviral exposure in pregnancy induces detrimental placenta vascular changes that are rescued by progesterone supplementation.Scientific reports · 2018Article
- Pregnancy Associated Plasma Protein-A and Placental Growth Factor in a Sub-Saharan African Population: A Nested Cross-Sectional Study.PloS one · 2016Article
- Eliminating preventable HIV-related maternal mortality in sub-Saharan Africa: what do we need to know?Journal of acquired immune deficiency syndromes (1999) · 2014Review
- Incidence of pregnancy after antiretroviral therapy initiation and associated factors in 8 West African countries.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- Gonadal function and reproductive health in women with human immunodeficiency virus infection.Endocrinology and metabolism clinics of North America · 2014Review
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundRisk 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.
methodsThe 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).
resultsPre-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.
conclusionsPre-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.
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