ArticleAIDS (London, England)2021
Differential impact of antiretroviral therapy initiated before or during pregnancy on placenta pathology in HIV-positive women.
Article in AIDS (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 27 citations in OpenAlex.
- Maternal adiposity and inflammatory immune trajectories during pregnancy in women with HIV.medRxiv : the preprint server for health sciences · 2026Article
- Risk assessment of drug-associated miscarriage using XGBoost and SHAP explainability: a real-world pharmacovigilance analysis based on the FAERS database.Frontiers in pharmacology · 2026Article
- Enrichment of the TRIM21-IgG complex in placental villi during HIV-1 infection.Frontiers in immunology · 2026Article
- Target trials of preconception switch from nevirapine or efavirenz-based antiretroviral therapy to dolutegravir-based antiretroviral therapy on adverse birth and maternal outcomes.AIDS (London, England) · 2025Article
- Structural brain differences in school-aged children who are HIV-exposed uninfected.BMC medicine · 2025Article
- Defining Appropriate Comparator Populations for Placental Pathology for Pregnant People With HIV.International journal of surgical pathology · 2025Article
- Prevalence and associated factors with low birth weight among human immunodeficiency virus exposed infants between 2004 and 2021 in Hubei, China: a retrospective cohort study.BMC public health · 2025Article
- Antiretroviral Therapy at Conception Leads to Lower Peripheral CD49aJournal of immunology research · 2025Article
- Cord blood innate-like T cell responses in neonates born to healthy women and women living with HIV.Frontiers in immunology · 2025Article
- Diminished placental Factor XIIIA1 expression associates with pre-conception antiretroviral treatment and preterm birth in pregnant people living with HIV.bioRxiv : the preprint server for biology · 2024Article
- Iron status, anemia, and birth outcomes among pregnant women in urban Bloemfontein, South Africa: the NuEMI study.BMC pregnancy and childbirth · 2024Article
- Challenges, risks, and opportunities of antiretroviral drugs in women of reproductive potential.Expert review of anti-infective therapy · 2024Review
- The impact of HIV and ART exposure during pregnancy on fetal growth: a prospective study in a South African cohort.BMC pregnancy and childbirth · 2023Article
- Adverse pregnancy outcomes associated with antiretroviral therapy initiated before pregnancy and during pregnancy: a retrospective study in Hubei province, China.Frontiers in medicine · 2023Article
- Preterm Birth in Women With HIV: The Role of the Placenta.Frontiers in global women's health · 2022Review
- T-Cell Homeostatic Imbalance in Placentas From Women With Human Immunodeficiency Virus in the Absence of Vertical Transmission.The Journal of infectious diseases · 2021Article
- Placental Findings in Term Singleton Stillbirths in a Public Hospital in Emalahleni Sub-District in Mpumalanga Province: A Descriptive Study.Public health nursing (Boston, Mass.)Observational
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11 authors at 5 institutions in 2 countries.
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Abstract
objectiveTo examine the association between timing of antiretroviral treatment (ART) initiation in HIV-infected women and placental histopathology.
designA nested substudy in a larger cohort of HIV-infected women which examined the association between ART status and birth outcomes.
methodsPlacentas (n = 130) were examined for histopathology from two ART groups: stable (n = 53), who initiated ART before conception and initiating (n = 77), who started ART during pregnancy [median (interquartile range) 15 weeks gestation (11-18)]. Using binomial regression we quantified associations between ART initiation timing with placental histopathology and pregnancy outcomes.
resultsOne-third of all placentas were less than 10th percentile weight-for-gestation and there was no significant difference between ART groups. Placental diameter, thickness, cord insertion position and foetal-placental weight ratio were also similar by group. However, placentas from the stable group showed increased maternal vascular malperfusion (MVM) (39.6 vs. 19.4%), and decreased weight (392 vs. 422 g, P = 0.09). MVM risk was twice as high [risk ratios 2.03 (95% confidence interval: 1.16-3.57); P = 0.01] in the stable group; the increased risk remaining significant when adjusting for maternal age [risk ratios 2.04 (95% confidence interval: 1.12-3.72); P = 0.02]. Furthermore, MVM was significantly associated with preterm delivery and low birth weight (P = 0.002 and <0.0001, respectively).
conclusionPreconception initiation of ART was associated with an increased MVM risk, and may contribute to placental dysfunction. The association between MVM with preterm delivery and low birth weight suggests that a placenta-mediated mechanism likely links the putative association between long-term use of ART and adverse birth outcomes.
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