دورية أكاديمية
أعرض في EDS

Maternal HIV, antiretroviral timing, and spontaneous preterm birth in an urban Zambian cohort: the role of local and systemic inflammation.

التفاصيل البيبلوغرافية
العنوان: Maternal HIV, antiretroviral timing, and spontaneous preterm birth in an urban Zambian cohort: the role of local and systemic inflammation.
المؤلفون: Rittenhouse KJ; University of North Carolina at Chapel Hill, Chapel Hill, USA.; University of North Carolina Global Projects-Zambia., Mwape H; University of North Carolina Global Projects-Zambia., Nelson JAE; University of North Carolina at Chapel Hill, Chapel Hill, USA., Mwale J; University of North Carolina Global Projects-Zambia., Chipili G; University of North Carolina Global Projects-Zambia., Price JT; University of North Carolina at Chapel Hill, Chapel Hill, USA.; University of North Carolina Global Projects-Zambia., Hudgens M; University of North Carolina at Chapel Hill, Chapel Hill, USA., Stringer EM; University of North Carolina at Chapel Hill, Chapel Hill, USA.; University of North Carolina Global Projects-Zambia., De Paris K; University of North Carolina at Chapel Hill, Chapel Hill, USA., Vwalika B; University of Zambia School of Medicine, Lusaka, Zambia., Stringer JSA; University of North Carolina at Chapel Hill, Chapel Hill, USA.; University of North Carolina Global Projects-Zambia.
المصدر: AIDS (London, England) [AIDS] 2021 Mar 15; Vol. 35 (4), pp. 555-565.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8710219 Publication Model: Print Cited Medium: Internet ISSN: 1473-5571 (Electronic) Linking ISSN: 02699370 NLM ISO Abbreviation: AIDS Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : London, England : Lippincott Williams & Wilkins
Original Publication: London : Gower Academic Journals, c1987-
مواضيع طبية MeSH: HIV Infections*/complications , HIV Infections*/drug therapy , Pregnancy Complications, Infectious*/drug therapy , Premature Birth*/epidemiology, Anti-Retroviral Agents/therapeutic use ; Female ; Humans ; Infant, Newborn ; Inflammation/drug therapy ; Pregnancy ; Zambia/epidemiology
مستخلص: Objective: To assess plasma and vaginal inflammation in three antenatal groups (HIV-uninfected women, HIV-infected women entering care on preconceptional ART, and HIV-infected women not on preconceptional ART) and whether these measures are associated with spontaneous preterm birth (sPTB).
Design: Case--control study nested within a pregnancy cohort in Lusaka, Zambia.
Methods: We analyzed 11 pro-inflammatory and two anti-inflammatory markers in 207 women with paired plasma and vaginal specimens collected between 16 and 20 gestational weeks. Among 51 HIV-infected women, we repeated the assays in 24-34-week samples. We used confirmatory factor analysis to create inflammation scores and compared them among the three groups.
Results: At baseline, HIV-infected women not on ART had higher vaginal pro-inflammatory scores than HIV-uninfected women [mean 0.37 (95% CI -0.06 to 0.80) vs. -0.02 (-0.32 to 0.27), P = 0.02]. In repeat testing, women not on preconceptional ART had an increase in vaginal inflammation between the baseline and 24-34-week visits compared with those continuing preconceptional ART [mean 0.62 (95% CI -0.80 to 4.20) vs. -0.07 (-2.78 to 2.11), P = 0.04]. In multivariate analyses, baseline vaginal inflammation predicted sPTB (aOR 1.5; 95% CI 1.0-2.3; P = 0.02). Plasma inflammation did not differ by HIV or ART exposure and was not associated with sPTB.
Conclusion: Women not receiving ART at entry into pregnancy care had more vaginal inflammation than women entering on treatment. They also experienced an increase in vaginal inflammation between the two sampling timepoints, possibly as a consequence of ART initiation. Vaginal (but not systemic) inflammation was associated with sPTB and offers a potential mechanistic insight into this important adverse birth outcome.
(Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
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معلومات مُعتمدة: D43 TW009340 United States TW FIC NIH HHS; K01 TW010857 United States TW FIC NIH HHS; P30 AI050410 United States AI NIAID NIH HHS; T32 HD075731 United States HD NICHD NIH HHS
سلسلة جزيئية: ClinicalTrials.gov NCT02738892
المشرفين على المادة: 0 (Anti-Retroviral Agents)
تواريخ الأحداث: Date Created: 20210104 Date Completed: 20210428 Latest Revision: 20230921
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC7944942
DOI: 10.1097/QAD.0000000000002808
PMID: 33394679
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-5571
DOI:10.1097/QAD.0000000000002808