ArticleThe Journal of infectious diseases2016
Low Prolactin and High 20-α-Hydroxysteroid Dehydrogenase Levels Contribute to Lower Progesterone Levels in HIV-Infected Pregnant Women Exposed to Protease Inhibitor-Based Combination Antiretroviral Therapy.
Article in The Journal of infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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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
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Comparative risk of adverse perinatal outcomes associated with classes of antiretroviral therapy in pregnant women living with HIV: systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Adverse perinatal outcomes associated with prenatal exposure to protease-inhibitor-based versus non-nucleoside reverse transcriptase inhibitor-based antiretroviral combinations in pregnant women with HIV infection: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Perinatal outcomes in women living with HIV-1 and receiving antiretroviral therapy-a systematic review and meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2022Pooled it
- Risk Factors for Adverse Birth Outcomes in the PROMISE 1077BF/1077FF Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Estradiol Levels Are Altered in Human Immunodeficiency Virus-Infected Pregnant Women Randomized to Efavirenz-Versus Lopinavir/Ritonavir-Based Antiretroviral Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.The New England journal of medicine · 2016Trial
- Joining the dots: maternal cytomegalovirus, HIV and the placenta.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025Review
- No Genetic Causal Relationship Between HIV Infection and Insulin Resistance, Diabetes: A Bidirectional Mendelian Randomization Analysis.Journal of multidisciplinary healthcare · 2025Article
- Growth-promoting hormonal alterations in pregnant women living with HIV receiving dolutegravir-based antiretroviral treatment are associated with lower infant 1-year weight z-scores.Frontiers in pediatrics · 2025Article
- Metabolomic profiling of preterm birth in pregnant women living with HIV.Metabolomics : Official journal of the Metabolomic Society · 2023Article
- Antiretroviral Therapy and Adverse Pregnancy Outcomes in People Living with HIV.The New England journal of medicine · 2023Review
- Circulating levels of inflammatory mediators in pregnant people living with HIV according to antiretroviral therapy regimen.Frontiers in microbiology · 2023Article
- Article
- Adverse perinatal outcomes associated with protease inhibitor-based antiretroviral therapy in pregnant women living with HIV: A systematic review and meta-analysis.EClinicalMedicine · 2022Article
- Protease Inhibitor Anti-HIV, Lopinavir, Impairs Placental Endocrine Function.International journal of molecular sciences · 2021Article
- The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy.Frontiers in cardiovascular medicine · 2021Review
- Brief Report: Markers of Spontaneous Preterm Delivery in Women Living With HIV: Relationship With Protease Inhibitors and Vitamin D.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Elevated systemic microbial translocation in pregnant HIV-infected women compared to HIV-uninfected women, and its inverse correlations with plasma progesterone levels.Journal of reproductive immunology · 2018Article
- HIV antiretroviral exposure in pregnancy induces detrimental placenta vascular changes that are rescued by progesterone supplementation.Scientific reports · 2018Article
- Elevated Levels of Estradiol in Human Immunodeficiency Virus-Infected Pregnant Women on Protease Inhibitor-Based Regimens.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIt has been reported that pregnant women receiving protease inhibitor (PI)-based combination antiretroviral therapy (cART) have lower levels of progesterone, which put them at risk of adverse birth outcomes, such as low birth weight. We sought to understand the mechanisms involved in this decline in progesterone level.
methodsWe assessed plasma levels of progesterone, prolactin, and lipids and placental expression of genes involved in progesterone metabolism in 42 human immunodeficiency virus (HIV)-infected and 31 HIV-uninfected pregnant women. In vitro studies and a mouse pregnancy model were used to delineate the effect of HIV from that of PI-based cART on progesterone metabolism.
resultsHIV-infected pregnant women receiving PI-based cART showed a reduction in plasma progesterone levels (P= .026) and an elevation in placental expression of the progesterone inactivating enzyme 20-α-hydroxysteroid dehydrogenase (20α-HSD; median, 2.5 arbitrary units [AU]; interquartile range [IQR], 1.00-4.10 AU), compared with controls (median, 0.89 AU; IQR, 0.66-1.26 AU;P= .002). Prolactin, a key regulator of 20α-HSD, was lower (P= .012) in HIV-infected pregnant women. We observed similar data in pregnant mice exposed to PI-based cART. In vitro inhibition of 20α-HSD activity in trophoblast cells reversed PI-based cART-induced decreases in progesterone levels.
conclusionsOur data suggest that the decrease in progesterone levels observed in HIV-infected pregnant women exposed to PI-based cART is caused, at least in part, by an increase in placental expression of 20α-HSD, which may be due to lower prolactin levels observed in these women.
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