Top

Current HIV/AIDS Reports

Published in:

01-02-2021 | Gestational Diabetes | HIV Pathogenesis and Treatment (AL Landay and NS Utay, Section Editors)

Non-communicable Diseases in Pregnant and Postpartum Women Living with HIV: Implications for Health Throughout the Life Course

Authors: Risa M. Hoffman, Caitlin Newhouse, Brian Chu, Jeffrey S. A. Stringer, Judith S. Currier

Published in: Current HIV/AIDS Reports | Issue 1/2021

Abstract

Purpose of Review

The development of non-communicable diseases (NCDs) in pregnant women living with HIV can be a harbinger of future NCD-related morbidity and mortality. This review focuses on the NCDs that complicate pregnancy and the postpartum period, including hypertensive complications, hyperglycemic disorders, excessive gestational weight gain, and bone mineral density losses. For each disease process, we explore the role of HIV as a possible driver of excess risk, the immediate consequences of these complications on pregnancy outcomes and maternal and infant health, and possible implications for long-term women’s health.

Recent Findings

Countries with the highest burden of HIV also shoulder a high burden of NCDs that complicate pregnancy, including hypertensive disorders, hyperglycemic disorders, weight gain, and osteopenia. This double burden of disease is a significant public health threat for reproductive-age women, with the potential for serious short- and long-term consequences for both women and their infants. Additionally, as the global first-line antiretroviral therapy regimens increasingly include integrase inhibitors, unhealthy weight gain associated with this drug class poses additional risk for NCD-related pregnancy complications and their persistence postpartum.

Summary

Further research is needed to better define prevalence of NCD complications in pregnancy, elucidate HIV-specific and traditional factors associated with poor outcomes, and to develop interventions to reduce risk and avoid downstream complications in those at highest risk.

Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130–7. https://doi.org/10.1053/j.semperi.2009.02.010.CrossRefPubMed

Deeks SG. HIV infection, inflammation, immunosenescence, and aging. Annu Rev Med. 2011;62:141–55. https://doi.org/10.1146/annurev-med-042909-093756.CrossRefPubMedPubMedCentral

World Health Organization. Tackling NCD’s: ‘Best buys’ and other recommended interventions for the prevention and control of noncommunicable disease. 2017 October. Available from: https://www.who.int/publications/i/item/WHO-NMH-NVI-17.9. Accessed 15 June 2020.

UNAIDS. Chronic care for HIV and noncommunicable diseases: how to leverage the HIV experience. 2011. Available from: https://www.unaids.org/sites/default/files/media_asset/20110526_JC2145_Chronic_care_of_HIV_0.pdf. Accessed 1 Aug 2020.

Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066–74. https://doi.org/10.1016/S0140-6736(06)68397-9.CrossRefPubMed

American College of Obstetrics and Gynecology. Gestational hypertension and preeclampsia: ACOG practice bulletin number 222. 2020;135(6):e237–e260.

Yucesoy G, Ozkan S, Bodur H, Tan T, Caliskan E, Vural B, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet. 2005;273(1):43–9. https://doi.org/10.1007/s00404-005-0741-3.CrossRefPubMed

Mwanri AW, Kinabo JL, Ramaiya K, Feskens EJ. High blood pressure and associated risk factors among women attending antenatal clinics in Tanzania. J Hypertens. 2015;33(5):940–7. https://doi.org/10.1097/HJH.0000000000000501.CrossRefPubMed

Stoner MC, Vwalika B, Smid MC, George S, Chi BH, Stringer EM, et al. A retrospective study of HIV, antiretroviral therapy, and pregnancy-associated hypertension among women in Lusaka, Zambia. Int J Gynaecol Obstet. 2016;134(3):299–303. https://doi.org/10.1016/j.ijgo.2016.03.014.CrossRefPubMedPubMedCentral

10.

Saums MK, King CC, Adams JC, Sheth AN, Badell ML, Young M, et al. Combination antiretroviral therapy and hypertensive disorders of pregnancy. Obstet Gynecol. 2019;134(6):1205–14. https://doi.org/10.1097/AOG.0000000000003584.CrossRefPubMedPubMedCentral

11.

Frank KA, Buchmann EJ, Schackis RC. Does human immunodeficiency virus infection protect against preeclampsia-eclampsia? Obstet Gynecol. 2004;104(2):238–42. https://doi.org/10.1097/01.AOG.0000130066.75671.b2.CrossRefPubMed

12.

Canlorbe G, Matheron S, Mandelbrot L, Oudet B, Luton D, Azria E. Vasculoplacental complications in pregnant women with HIV infection: a case-control study. Am J Obstet Gynecol. 2015;213(2):241 e1–9. https://doi.org/10.1016/j.ajog.2015.03.035.CrossRefPubMed

13.

Browne JL, Schrier VJ, Grobbee DE, Peters SA, Klipstein-Grobusch K. HIV, antiretroviral therapy, and hypertensive disorders in pregnancy: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2015;70(1):91–8. https://doi.org/10.1097/QAI.0000000000000686.CrossRefPubMed

14.

Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308(5728):1592–4. https://doi.org/10.1126/science.1111726.CrossRefPubMed

15.

Germain SJ, Sacks GP, Sooranna SR, Sargent IL, Redman CW. Systemic inflammatory priming in normal pregnancy and preeclampsia: the role of circulating syncytiotrophoblast microparticles. J Immunol. 2007;178(9):5949–56. https://doi.org/10.4049/jimmunol.178.9.5949.CrossRefPubMed

16.

Martinez-Varea A, Pellicer B, Perales-Marin A, Pellicer A. Relationship between maternal immunological response during pregnancy and onset of preeclampsia. J Immunol Res. 2014;2014:210241–15. https://doi.org/10.1155/2014/210241.CrossRefPubMedPubMedCentral

17.

Sebitloane HM, Moodley J, Sartorius B. Associations between HIV, highly active anti-retroviral therapy, and hypertensive disorders of pregnancy among maternal deaths in South Africa 2011-2013. Int J Gynaecol Obstet. 2017;136(2):195–9. https://doi.org/10.1002/ijgo.12038.CrossRefPubMed

18.

Wimalasundera RC, Larbalestier N, Smith JH, de Ruiter A, Mc GTSA, Hughes AD, et al. Pre-eclampsia, antiretroviral therapy, and immune reconstitution. Lancet. 2002;360(9340):1152–4. https://doi.org/10.1016/s0140-6736(02)11195-0.CrossRefPubMed

19.

Sansone M, Sarno L, Saccone G, Berghella V, Maruotti GM, Migliucci A, et al. Risk of preeclampsia in human immunodeficiency virus-infected pregnant women. Obstet Gynecol. 2016;127(6):1027–32. https://doi.org/10.1097/AOG.0000000000001424.CrossRefPubMed

20.

Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386–93. https://doi.org/10.1038/hr.2010.9.CrossRefPubMed

21••.

Venter WDF, Moorhouse M, Sokhela S, Fairlie L, Mashabane N, Masenya M, et al. Dolutegravir plus two different prodrugs of tenofovir to treat HIV. N Engl J Med. 2019;381(9):803–15. https://doi.org/10.1056/NEJMoa1902824This study provides important data about weight gain associated with dolutegravir in combination with either TDF or TAF.CrossRefPubMed

22.

Group NAS, Kouanfack C, Mpoudi-Etame M, Omgba Bassega P, Eymard-Duvernay S, Leroy S, et al. Dolutegravir-based or low-dose efavirenz-based regimen for the treatment of HIV-1. N Engl J Med. 2019;381(9):816–26. https://doi.org/10.1056/NEJMoa1904340.CrossRef

23.

Zash R, Williams PL, Jacobson D, Diseko MO, Mayondi G, Mabuta J, et al. Increased risk of hypertension in pregnancy among women on nevirapine- based regimens. Presented at CROI 2018; 2018 march 4–7; Boston, Massachusetts . Available from: https://www.croiconference.org/abstract/increased-risk-hypertension-pregnancy-among-women-nevirapine-based-regimens/. Accessed 20 July 2020.

24.

Reiter L, Brown MA, Whitworth JA. Hypertension in pregnancy: the incidence of underlying renal disease and essential hypertension. Am J Kidney Dis. 1994;24(6):883–7. https://doi.org/10.1016/s0272-6386(12)81055-9.CrossRefPubMed

25.

Theilen LH, Meeks H, Fraser A, Esplin MS, Smith KR, Varner MW. Long-term mortality risk and life expectancy following recurrent hypertensive disease of pregnancy. Am J Obstet Gynecol. 2018;219(1):107 e1–e6. https://doi.org/10.1016/j.ajog.2018.04.002.CrossRefPubMedPubMedCentral

26.

Mongraw-Chaffin ML, Cirillo PM, Cohn BA. Preeclampsia and cardiovascular disease death: prospective evidence from the child health and development studies cohort. Hypertension. 2010;56(1):166–71. https://doi.org/10.1161/HYPERTENSIONAHA.110.150078.CrossRefPubMed

27.

Watanabe M, Sairenchi T, Nishida K, Uchiyama K, Haruyama Y, Satonaka H et al. Gestational hypertension as risk factor of hypertension in middle-aged and older women. Int J Environ Res Public Health. 2020;17(11). https://doi.org/10.3390/ijerph17114052.

28.

Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335(7627):974. https://doi.org/10.1136/bmj.39335.385301.BE.CrossRefPubMedPubMedCentral

29.

Zicari S, Sessa L, Cotugno N, Ruggiero A, Morrocchi E, Concato C et al. Immune activation, inflammation, and non-AIDS co-morbidities in HIV-infected patients under long-term ART. Viruses. 2019;11(3). https://doi.org/10.3390/v11030200.

30.

Vatten LJ, Romundstad PR, Holmen TL, Hsieh CC, Trichopoulos D, Stuver SO. Intrauterine exposure to preeclampsia and adolescent blood pressure, body size, and age at menarche in female offspring. Obstet Gynecol. 2003;101(3):529–33. https://doi.org/10.1016/s0029-7844(02)02718-7.CrossRefPubMed

31.

Tenhola S, Rahiala E, Halonen P, Vanninen E, Voutilainen R. Maternal preeclampsia predicts elevated blood pressure in 12-year-old children: evaluation by ambulatory blood pressure monitoring. Pediatr Res. 2006;59(2):320–4. https://doi.org/10.1203/01.pdr.0000196734.54473.e3.CrossRefPubMed

32.

Metzger BE, Coustan DR. Proceedings of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 1998; 2:B1. Available from: http://journal.diabetes.org/diabetescare/supplement298/B161.htm. Accessed 8 July 2020.

33.

Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11). https://doi.org/10.3390/ijms19113342.

34.

Hedderson MM, Williams MA, Holt VL, Weiss NS, Ferrara A. Body mass index and weight gain prior to pregnancy and risk of gestational diabetes mellitus. Am J Obstet Gynecol. 2008;198(4):409 e1–7. https://doi.org/10.1016/j.ajog.2007.09.028.CrossRefPubMedPubMedCentral

35.

Gibson KS, Waters TP, Catalano PM. Maternal weight gain in women who develop gestational diabetes mellitus. Obstet Gynecol. 2012;119(3):560–5. https://doi.org/10.1097/AOG.0b013e31824758e0.CrossRefPubMed

36.

Carreno CA, Clifton RG, Hauth JC, Myatt L, Roberts JM, Spong CY, et al. Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstet Gynecol. 2012;119(6):1227–33. https://doi.org/10.1097/AOG.0b013e318256cf1a.CrossRefPubMedPubMedCentral

37.

American Diabetes A. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S14–31. https://doi.org/10.2337/dc20-S002.CrossRef

38.

International Association of D, Pregnancy Study Groups Consensus P, Metzger BE, Gabbe SG, Persson B, Buchanan TA, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82. https://doi.org/10.2337/dc09-1848.CrossRef

39.

Caughey AB, Turrentine M. ACOG practice bulletin no. 190: gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49–64. https://doi.org/10.1097/AOG.0000000000002501 Available from: https://pubmed.ncbi.nlm.nih.gov/29370047/. Accessed 10 June 2020.CrossRef

40.

WHO Reproductive Health Library. WHO recommendation on the diagnosis of gestational diabetes in pregnancy. 2016 December. Available from: https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/antenatal-care/who-recommendation-diagnosis-gestational-diabetes-pregnancy-0. Accessed 1, July 2020.

41.

Harper LM, Mele L, Landon MB, Carpenter MW, Ramin SM, Reddy UM, et al. Carpenter-Coustan compared with National Diabetes Data Group Criteria for diagnosing gestational diabetes. Obstet Gynecol. 2016;127(5):893–8. https://doi.org/10.1097/AOG.0000000000001383.CrossRefPubMedPubMedCentral

42.

Schneider S, Bock C, Wetzel M, Maul H, Loerbroks A. The prevalence of gestational diabetes in advanced economies. J Perinat Med. 2012;40(5):511–20. https://doi.org/10.1515/jpm-2012-0015.CrossRefPubMed

43.

Anzaku AS, Musa J. Prevalence and associated risk factors for gestational diabetes in Jos, North-central, Nigeria. Arch Gynecol Obstet. 2013;287(5):859–63. https://doi.org/10.1007/s00404-012-2649-z.CrossRefPubMed

44.

Seyoum B, Kiros K, Haileselase T, Leole A. Prevalence of gestational diabetes mellitus in rural pregnant mothers in northern Ethiopia. Diabetes Res Clin Pract. 1999;46(3):247–51. https://doi.org/10.1016/s0168-8227(99)00101-1.CrossRefPubMed

45.

Mamabolo RL, Alberts M, Levitt NS, Delemarre-van de Waal HA, Steyn NP. Prevalence of gestational diabetes mellitus and the effect of weight on measures of insulin secretion and insulin resistance in third-trimester pregnant rural women residing in the central region of Limpopo Province, South Africa. Diabet Med. 2007;24(3):233–9. https://doi.org/10.1111/j.1464-5491.2006.02073.x.CrossRefPubMed

46.

Biadgo B, Ambachew S, Abebe M, Melku M. Gestational diabetes mellitus in HIV-infected pregnant women: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;155:107800. https://doi.org/10.1016/j.diabres.2019.107800.CrossRefPubMed

47.

Jao J, Wong M, Van Dyke RB, Geffner M, Nshom E, Palmer D, et al. Gestational diabetes mellitus in HIV-infected and -uninfected pregnant women in Cameroon. Diabetes Care. 2013;36(9):e141–2. https://doi.org/10.2337/dc13-0968.CrossRefPubMedPubMedCentral

48.

Gonzalez-Tome MI, Ramos Amador JT, Guillen S, Solis I, Fernandez-Ibieta M, Munoz E, et al. Gestational diabetes mellitus in a cohort of HIV-1 infected women. HIV Med. 2008;9(10):868–74. https://doi.org/10.1111/j.1468-1293.2008.00639.x.CrossRefPubMed

49.

Chebrolu P, Alexander M, Bhosale R, Naik S, Patil N, Gupte N, et al. Factors associated with gestational diabetes in HIV-infected and HIV-uninfected women in Pune, India. Presented at: CROI 2020; 2020 march 8–11; Boston, Massachusetts. Available from: https://2jg4quetidw2blbbq2ixwziw-wpengine.netdna-ssl.com/wp-content/uploads/sites/2/posters/2020/1430_7_Chebrolu_00774.pdf. Accessed 25 July 2020.

50.

Tripathi A, Liese AD, Jerrell JM, Zhang J, Rizvi AA, Albrecht H, et al. Incidence of diabetes mellitus in a population-based cohort of HIV-infected and non-HIV-infected persons: the impact of clinical and therapeutic factors over time. Diabet Med. 2014;31(10):1185–93. https://doi.org/10.1111/dme.12455.CrossRefPubMed

51.

Hruz PW. HIV protease inhibitors and insulin resistance: lessons from in-vitro, rodent and healthy human volunteer models. Curr Opin HIV AIDS. 2008;3(6):660–5. https://doi.org/10.1097/COH.0b013e3283139134.CrossRefPubMedPubMedCentral

52.

Lee GA, Rao MN, Grunfeld C. The effects of HIV protease inhibitors on carbohydrate and lipid metabolism. Curr HIV/AIDS Rep. 2005;2(1):39–50. https://doi.org/10.1007/s11904-996-0008-z.CrossRefPubMed

53.

Soepnel LM, Norris SA, Schrier VJ, Browne JL, Rijken MJ, Gray G, et al. The association between HIV, antiretroviral therapy, and gestational diabetes mellitus. AIDS. 2017;31(1):113–25. https://doi.org/10.1097/QAD.0000000000001277.CrossRefPubMed

54.

Mmasa KN, Powis K, Makhema J, Moyo S, Gerschenson M, Mohammed T, et al. Gestational diabetes in women on dolutegravir- or efavirez-based ART in Botswana. Presented at: CROI 2018; 2018 March 4–7; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/gestational-diabetes-women-dolutegravir-or-efavirenz-based-art-botswana/. Accessed 13 Jun 2020.

55.

Wilson C. Hepatitis C infection and type 2 diabetes in American-Indian women. Diabetes Care. 2004;27(9):2116–9. https://doi.org/10.2337/diacare.27.9.2116.CrossRefPubMed

56.

Pergam SA, Wang CC, Gardella CM, Sandison TG, Phipps WT, Hawes SE. Pregnancy complications associated with hepatitis C: data from a 2003–2005 Washington state birth cohort. Am J Obstet Gynecol. 2008;199(1):38 e1–9. https://doi.org/10.1016/j.ajog.2008.03.052.CrossRefPubMedPubMedCentral

57.

Cordero L, Treuer SH, Landon MB, Gabbe SG. Management of infants of diabetic mothers. Arch Pediatr Adolesc Med. 1998;152(3):249–54. https://doi.org/10.1001/archpedi.152.3.249.CrossRefPubMed

58.

Kong L, Nilsson IAK, Gissler M, Lavebratt C. Associations of maternal diabetes and body mass index with offspring birth weight and prematurity. JAMA Pediatr. 2019;173(4):371–8. https://doi.org/10.1001/jamapediatrics.2018.5541.CrossRefPubMedPubMedCentral

59.

Gregory KD, Henry OA, Ramicone E, Chan LS, Platt LD. Maternal and infant complications in high and normal weight infants by method of delivery. Obstet Gynecol. 1998;92(4 Pt 1):507–13. https://doi.org/10.1016/s0029-7844(98)00224-5.CrossRefPubMed

60.

Becerra JE, Khoury MJ, Cordero JF, Erickson JD. Diabetes mellitus during pregnancy and the risks for specific birth defects: a population-based case-control study. Pediatrics. 1990;85(1):1–9.PubMed

61.

Rosenstein MG, Cheng YW, Snowden JM, Nicholson JM, Doss AE, Caughey AB. The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol. 2012;206(4):309 e1–7. https://doi.org/10.1016/j.ajog.2012.01.014.CrossRefPubMedPubMedCentral

62.

Vaarasmaki M, Pouta A, Elliot P, Tapanainen P, Sovio U, Ruokonen A, et al. Adolescent manifestations of metabolic syndrome among children born to women with gestational diabetes in a general-population birth cohort. Am J Epidemiol. 2009;169(10):1209–15. https://doi.org/10.1093/aje/kwp020.CrossRefPubMed

63.

Clausen TD, Mathiesen ER, Hansen T, Pedersen O, Jensen DM, Lauenborg J, et al. Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes. J Clin Endocrinol Metab. 2009;94(7):2464–70. https://doi.org/10.1210/jc.2009-0305.CrossRefPubMed

64.

Soepnel LM, Nicolaou V, Huddle KRL, Klipstein-Grobusch K, Levitt NS, Norris SA. Maternal and neonatal outcomes following a diabetic pregnancy within the context of HIV. Int J Gynaecol Obstet. 2019;147(3):404–12. https://doi.org/10.1002/ijgo.12956.CrossRefPubMed

65.

Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;369:m1361. https://doi.org/10.1136/bmj.m1361.CrossRefPubMedPubMedCentral

66.

Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care. 2008;31(8):1668–9. https://doi.org/10.2337/dc08-0706.CrossRefPubMedPubMedCentral

67.

Kessous R, Shoham-Vardi I, Pariente G, Sherf M, Sheiner E. An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity. Heart. 2013;99(15):1118–21. https://doi.org/10.1136/heartjnl-2013-303945.CrossRefPubMed

68.

Stone L, Looby SE, Zanni MV. Cardiovascular disease risk among women living with HIV in North America and Europe. Curr Opin HIV AIDS. 2017;12(6):585–93. https://doi.org/10.1097/COH.0000000000000413.CrossRefPubMedPubMedCentral

69.

Alonso A, Barnes AE, Guest JL, Shah A, Shao IY, Marconi V. HIV infection and incidence of cardiovascular diseases: an analysis of a large healthcare database. J Am Heart Assoc. 2019;8(14):e012241. https://doi.org/10.1161/JAHA.119.012241.CrossRefPubMedPubMedCentral

70.

Kitzmiller JL, Dang-Kilduff L, Taslimi MM. Gestational diabetes after delivery. Short-term management and long-term risks. Diabetes Care. 2007;30(Suppl 2):S225–35. https://doi.org/10.2337/dc07-s221.CrossRefPubMed

71.

Varner MW, Rice MM, Landon MB, Casey BM, Reddy UM, Wapner RJ, et al. Pregnancies after the diagnosis of mild gestational diabetes mellitus and risk of cardiometabolic disorders. Obstet Gynecol. 2017;129(2):273–80. https://doi.org/10.1097/AOG.0000000000001863.CrossRefPubMedPubMedCentral

72.

Koethe JR, Heimburger DC. Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. Am J Clin Nutr. 2010;91(4):1138S–42S. https://doi.org/10.3945/ajcn.2010.28608D.CrossRefPubMedPubMedCentral

73.

Kumar S, Samaras K. The impact of weight gain during HIV treatment on risk of pre-diabetes, diabetes mellitus, cardiovascular disease, and mortality. Front Endocrinol (Lausanne). 2018;9:705. https://doi.org/10.3389/fendo.2018.00705.CrossRef

74.

Anuurad E, Bremer A, Berglund L. HIV protease inhibitors and obesity. Curr Opin Endocrinol Diabetes Obes. 2010;17(5):478–85. https://doi.org/10.1097/MED.0b013e32833dde87.CrossRefPubMedPubMedCentral

75.

Periard D, Telenti A, Sudre P, Cheseaux JJ, Halfon P, Reymond MJ, et al. Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. The Swiss HIV Cohort Study. Circulation. 1999;100(7):700–5. https://doi.org/10.1161/01.cir.100.7.700.CrossRefPubMed

76.

Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998;12(7):F51–8. https://doi.org/10.1097/00002030-199807000-00003.CrossRefPubMed

77.

Bhagwat P, Ofotokun I, McComsey GA, Brown TT, Moser C, Sugar CA, et al. Changes in waist circumference in HIV-infected individuals initiating a raltegravir or protease inhibitor regimen: effects of sex and race. Open Forum Infect Dis. 2018;5(11):ofy201. https://doi.org/10.1093/ofid/ofy201.CrossRefPubMedPubMedCentral

78.

Venter F, Moorhouse M, Sokhela S, Chandiwana N, Akpomiemie, Qavi A, et al. Dolutegravir, emtricitabine plus two prodrugs of tenofovir for the treatment of HIV-1 infection: advance trial. 2020. Available from: https://www.hivandmore.de/kongresse/iac2020/Sokhela_The-ADVANCE-trial_AIDS2020_OAXLB0104.pdf. Accessed 9 Aug 2020.

79.

Hill A, McCann KM, Pilkington V, Moorhouse MA, Sokhela S, Serenata C, et al. Risks of metabolic syndrome, diabetes, and cardiovascular disease in advance trial. Presented at: CROI 2020; 2020 March 8–11; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/risks-of-metabolic-syndrome-diabetes-and-cardiovascular-disease-in-advance-trial/. Accessed 13 Jun 2020.

80.

Bourgi K, Jenkins CA, Rebeiro PF, Palella F, Moore RD, Altoff KN, et al. Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada. J Int AIDS Soc. 2020;23(4):e25484. https://doi.org/10.1002/jia2.25484.CrossRefPubMedPubMedCentral

81.

Bourgi K, Rebeiro PF, Turner M, Castilho JL, Hulgan T, Raffanti SP, et al. Greater weight gain in treatment-naive persons starting dolutegravir-based antiretroviral therapy. Clin Infect Dis. 2020;70(7):1267–74. https://doi.org/10.1093/cid/ciz407.CrossRefPubMed

82.

Norwood J, Turner M, Bofill C, Rebeiro P, Shepherd B, Bebawy S, et al. Brief report: weight gain in persons with HIV switched from efavirenz-based to integrase strand transfer inhibitor-based regimens. J Acquir Immune Defic Syndr. 2017;76(5):527–31. https://doi.org/10.1097/QAI.0000000000001525.CrossRefPubMedPubMedCentral

83.

Lake JE, Wu K, Bares SH, Debroy P, Godfrey C, Koethe JR, et al. Risk factors for weight gain following switch to integrase inhibitor-based antiretroviral therapy. Clin Infect Dis. 2020;71:e471–7. https://doi.org/10.1093/cid/ciaa177.CrossRefPubMedPubMedCentral

84.

Taramasso L, Bonfanti P, Ricci E, Orofino G, Squillace N, Menzaghi B, et al. Factors associated with weight gain in people treated with dolutegravir. Open Forum Infect Dis. 2020;7(6):ofaa195. https://doi.org/10.1093/ofid/ofaa195.CrossRefPubMedPubMedCentral

85.

Goldstein RF, Abell SK, Ranasinha S, Misso ML, Boyle JA, Harrison CL, et al. Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women. BMC Med. 2018;16(1):153. https://doi.org/10.1186/s12916-018-1128-1.CrossRefPubMedPubMedCentral

86.

Onubi OJ, Marais D, Aucott L, Okonofua F, Poobalan AS. Maternal obesity in Africa: a systematic review and meta-analysis. J Public Health (Oxf). 2016;38(3):e218–e31. https://doi.org/10.1093/pubmed/fdv138.CrossRef

87.

Caniglia E, Shapiro R, Diseko M, Wylie B, Zera C, Davey S, et al. Weight gain during pregnancy among women initiating dolutegravir in Botswana. Presented at: IAS 2019; 21–24 July 2019; Mexico City, Mexico. Available from: http://programme.ias2019.org/Abstract/Abstract/4824. Accessed 1 Aug 2020.

88.

Jao J, Sun S, Legbedze J, Jacobson D, Mmasa KN, Kgole SW, et al. Dolutegravir use is associated with higher postpartum weight compared to efavirenz. Presented at: CROI 2020; 2020 march 8–11; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/dolutegravir-use-is-associated-with-higher-postpartum-weight-compared-to-efavirenz/. Accessed 6 Aug 2020.

89.

Malaba TR, Chen T, Kintu K, Papamichael C, Reynolds H, Nakibuka J, et al. Postpartum weight changes in women initiating dtg vs efv in pregnancy: dolphin-2. Presented at: CROI 2020; 2020 March 8–11; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/postpartum-weight-changes-in-women-initiating-dtg-vs-efv-in-pregnancy-dolphin-2/. Accessed 25 July 2020.

90.

Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K, Bennett WL, Bolen S, et al. Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes. Evid Rep Technol Assess (Full Rep). 2008;162:1–96.

91.

Baptiste-Roberts K, Barone BB, Gary TL, Golden SH, Wilson LM, Bass EB, et al. Risk factors for type 2 diabetes among women with gestational diabetes: a systematic review. Am J Med. 2009;122(3):207–14 e4. https://doi.org/10.1016/j.amjmed.2008.09.034.CrossRefPubMedPubMedCentral

92.

Dornhorst A, Bailey PC, Anyaoku V, Elkeles RS, Johnston DG, Beard RW. Abnormalities of glucose tolerance following gestational diabetes. Q J Med. 1990;77(284):1219–28. https://doi.org/10.1093/qjmed/77.3.1219.CrossRefPubMed

93.

O'Sullivan JB. Diabetes mellitus after GDM. Diabetes. 1991;40(Suppl 2):131–5. https://doi.org/10.2337/diab.40.2.s131.CrossRefPubMed

94.

Sarkar M, Grab J, Dodge JL, Gunderson EP, Rubin J, Irani RA, et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes. J Hepatol. 2020;73:516–22. https://doi.org/10.1016/j.jhep.2020.03.049.CrossRefPubMedPubMedCentral

95.

Graff M, North KE, Franceschini N, Reiner AP, Feitosa M, Carr JJ, et al. PNPLA3 gene-by-visceral adipose tissue volume interaction and the pathogenesis of fatty liver disease: the NHLBI family heart study. Int J Obes. 2013;37(3):432–8. https://doi.org/10.1038/ijo.2012.65.CrossRef

96.

Ayonrinde OT, Olynyk JK, Beilin LJ, Mori TA, Pennell CE, de Klerk N, et al. Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology. 2011;53(3):800–9. https://doi.org/10.1002/hep.24097.CrossRefPubMed

97.

Mazzola G, Cervo A, Guaraldi G, Krahn T, Milic J, De Luca A, et al. NAFLD and liver fibrosis predict high cardiovascular risk in HIV- monoinfected patient. Presented at: CROI 2020; 2020 march 8–11; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/nafld-and-liver-fibrosis-predict-high-cardiovascular-risk-in-hiv-monoinfected-patient/. Accessed 3 July 2020.

98•.

Asif SBE, Hill A, et al. The predicted risk of adverse pregnancy outcomes from treatment-induced obesity in the ADVANCE trial. AIDS 2020: 23rd international AIDS conference virtual. July 6-10, 2020. Abstract OABLB0103. Available at https://www.natap.org/2020/IAC/2020AIDSConf_PregnancyPredictions_Finaluploaded2.pdfAccessed July 6, 2020. This study provides data about the possible implications of adverse pregnancy outcomes from treatment-induced obesity related to dolutegravir.

99.

Becofsky K, Wing EJ, McCaffery J, Boudreau M, Wing RR. A randomized controlled trial of a behavioral weight loss program for human immunodeficiency virus-infected patients. Clin Infect Dis. 2017;65(1):154–7. https://doi.org/10.1093/cid/cix238.CrossRefPubMedPubMedCentral

100.

Duncan AD, Peters BS, Rivas C, Goff LM. Reducing risk of type 2 diabetes in HIV: a mixed-methods investigation of the STOP-diabetes diet and physical activity intervention. Diabet Med. 2019. https://doi.org/10.1111/dme.13927.

101.

Engelson ES, Agin D, Kenya S, Werber-Zion G, Luty B, Albu JB, et al. Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. Metabolism. 2006;55(10):1327–36. https://doi.org/10.1016/j.metabol.2006.05.018.CrossRefPubMed

102.

Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359(9321):1929–36. https://doi.org/10.1016/S0140-6736(02)08761-5.CrossRefPubMed

103.

Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review. AIDS. 2006;20(17):2165–74. https://doi.org/10.1097/QAD.0b013e32801022eb.CrossRefPubMed

104.

Raynaud-Messina B, Bracq L, Dupont M, Souriant S, Usmani SM, Proag A, et al. Bone degradation machinery of osteoclasts: an HIV-1 target that contributes to bone loss. Proc Natl Acad Sci U S A. 2018;115(11):E2556–E65. https://doi.org/10.1073/pnas.1713370115.CrossRefPubMedPubMedCentral

105.

McComsey GA, Tebas P, Shane E, Yin MT, Overton ET, Huang JS, et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin Infect Dis. 2010;51(8):937–46. https://doi.org/10.1086/656412.CrossRefPubMed

106.

World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 1994. Available from: https://apps.who.int/iris/bitstream/handle/10665/39142/WHO_TRS_843.pdf;jsessionid=189448C27066A24A51EA1184EAC5A4C9?sequence=1. Accessed 28 June 2020.

107.

Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML, et al. International Society for Clinical Densitometry 2007 adult and pediatric official positions. Bone. 2008;43(6):1115–21. https://doi.org/10.1016/j.bone.2008.08.106.CrossRefPubMed

108.

Brown TT, McComsey GA, King MS, Qaqish RB, Bernstein BM, da Silva BA. Loss of bone mineral density after antiretroviral therapy initiation, independent of antiretroviral regimen. J Acquir Immune Defic Syndr. 2009;51(5):554–61. https://doi.org/10.1097/QAI.0b013e3181adce44.CrossRefPubMed

109.

Bonjoch A, Figueras M, Estany C, Perez-Alvarez N, Rosales J, del Rio L, et al. High prevalence of and progression to low bone mineral density in HIV-infected patients: a longitudinal cohort study. AIDS. 2010;24(18):2827–33. https://doi.org/10.1097/QAD.0b013e328340a28d.CrossRefPubMed

110.

McComsey GA, Kitch D, Daar ES, Tierney C, Jahed NC, Tebas P, et al. Bone mineral density and fractures in antiretroviral-naive persons randomized to receive abacavir-lamivudine or tenofovir disoproxil fumarate-emtricitabine along with efavirenz or atazanavir-ritonavir: aids clinical trials group A5224s, a substudy of ACTG A5202. J Infect Dis. 2011;203(12):1791–801. https://doi.org/10.1093/infdis/jir188.CrossRefPubMedPubMedCentral

111.

Haskelberg H, Mallon PW, Hoy J, Amin J, Moore C, Phanuphak P, et al. Bone mineral density over 96 weeks in adults failing first-line therapy randomized to raltegravir/lopinavir/ritonavir compared with standard second-line therapy. J Acquir Immune Defic Syndr. 2014;67(2):161–8. https://doi.org/10.1097/QAI.0000000000000288.CrossRefPubMed

112.

Sax PE, Wohl D, Yin MT, Post F, DeJesus E, Saag M, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate, coformulated with elvitegravir, cobicistat, and emtricitabine, for initial treatment of HIV-1 infection: two randomised, double-blind, phase 3, non-inferiority trials. Lancet. 2015;385(9987):2606–15. https://doi.org/10.1016/S0140-6736(15)60616-X.CrossRefPubMed

113.

Wohl D, Oka S, Clumeck N, Clarke A, Brinson C, Stephens J, et al. Brief report: a randomized, double-blind comparison of tenofovir alafenamide versus tenofovir disoproxil fumarate, each coformulated with elvitegravir, cobicistat, and emtricitabine for initial HIV-1 treatment: week 96 results. J Acquir Immune Defic Syndr. 2016;72(1):58–64. https://doi.org/10.1097/QAI.0000000000000940.CrossRefPubMed

114.

Kovacs CS, Ralston SH. Presentation and management of osteoporosis presenting in association with pregnancy or lactation. Osteoporos Int. 2015;26(9):2223–41. https://doi.org/10.1007/s00198-015-3149-3.CrossRefPubMed

115.

Kurabayashi T, Nagata H, Takeyama N, Matsushita H, Tanaka K. Bone mineral density measurement in puerperal women as a predictor of persistent osteopenia. J Bone Miner Metab. 2009;27(2):205–12. https://doi.org/10.1007/s00774-008-0028-4.CrossRefPubMed

116.

Salari P, Abdollahi M. The influence of pregnancy and lactation on maternal bone health: a systematic review. J Family Reprod Health. 2014;8(4):135–48.PubMedPubMedCentral

117.

• Nabwire F, Prentice A, Hamill MM, Fowler MG, Byamugisha J, Kekitiinwa A, et al. Changes in bone mineral density during and after lactation in Ugandan women with HIV on tenofovir-based antiretroviral therapy. J Bone Miner Res. 2020. https://doi.org/10.1002/jbmr.4121. This study suggests that women with HIV on TDF-based ART do not achieve complete recovery of bone density after lactation.

118.

Tierney C, Marr C, George K, Sebikai D, Dadabhai S, Zanga A, et al. Impact of tenofovir-containing triple antiretroviral therapy (ART) on bone mineral density in HIV-infected breastfeeding women in sub-Saharan Africa. Presented at: 8^th International Workshop on HIV Pediatrics; 15-16 July 2016; Durban, South Africa Available from: https://impaactnetwork.org/DocFiles/AIDS2016/PedsWorkshop/P1084s_Stranix_maternalDXA_PdsWksp2016.pdf. Accessed 1 Aug 2020.

119.

Eckard AR, Mora S. Bone health in HIV-infected children and adolescents. Curr Opin HIV AIDS. 2016;11(3):294–300. https://doi.org/10.1097/COH.0000000000000270.CrossRefPubMedPubMedCentral

120.

Mofenson LM, Baggaley RC, Mameletzis I. Tenofovir disoproxil fumarate safety for women and their infants during pregnancy and breastfeeding. AIDS. 2017;31(2):213–32. https://doi.org/10.1097/QAD.0000000000001313.CrossRefPubMed

121.

Sharma A, Shi Q, Hoover DR, Anastos K, Tien PC, Young MA, et al. Increased fracture incidence in middle-aged HIV-infected and HIV-uninfected women: updated results from the women’s interagency HIV study. J Acquir Immune Defic Syndr. 2015;70(1):54–61. https://doi.org/10.1097/QAI.0000000000000674.CrossRefPubMedPubMedCentral

122.

Erlandson KM, Lake JE, Sim M, Falutz J, Prado CM, Domingues da Silva AR, et al. Bone mineral density declines twice as quickly among HIV-infected women compared with men. J Acquir Immune Defic Syndr. 2018;77(3):288–94. https://doi.org/10.1097/QAI.0000000000001591.CrossRefPubMedPubMedCentral

123.

Calmy A, Chevalley T, Delhumeau C, Toutous-Trellu L, Spycher-Elbes R, Ratib O, et al. Long-term HIV infection and antiretroviral therapy are associated with bone microstructure alterations in premenopausal women. Osteoporos Int. 2013;24(6):1843–52. https://doi.org/10.1007/s00198-012-2189-1.CrossRefPubMed

124.

Prior J, Burdge D, Maan E, Milner R, Hankins C, Klein M, et al. Fragility fractures and bone mineral density in HIV positive women: a case-control population-based study. Osteoporos Int. 2007;18(10):1345–53. https://doi.org/10.1007/s00198-007-0428-7.CrossRefPubMed

125.

Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA, et al. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):1–10. https://doi.org/10.1093/cid/cit757.CrossRefPubMed

126.

Kanis JA, McCloskey E, Johansson H, Oden A, Leslie WD. FRAX((R)) with and without bone mineral density. Calcif Tissue Int. 2012;90(1):1–13. https://doi.org/10.1007/s00223-011-9544-7.CrossRefPubMed

127.

FRAX: Fracture risk assessment tool. University of Sheffield, UK. 2010. Available from: https://www.sheffield.ac.uk/FRAX/index.aspx. Accessed June 20, 2020.

128.

Yin MT, Falutz J. How to predict the risk of fracture in HIV? Curr Opin HIV AIDS. 2016;11(3):261–7. https://doi.org/10.1097/COH.0000000000000273.CrossRefPubMedPubMedCentral

129.

Overton ET, Chan ES, Brown TT, Tebas P, McComsey GA, Melbourne KM, et al. Vitamin D and calcium attenuate bone loss with antiretroviral therapy initiation: a randomized trial. Ann Intern Med. 2015;162(12):815–24. https://doi.org/10.7326/M14-1409.CrossRefPubMedPubMedCentral

130.

Havens PL, Stephensen CB, Van Loan MD, Schuster GU, Woodhouse LR, Flynn PM, et al. Vitamin D3 supplementation increases spine bone mineral density in adolescents and young adults with human immunodeficiency virus infection being treated with tenofovir disoproxil fumarate: a randomized, placebo-controlled trial. Clin Infect Dis. 2018;66(2):220–8. https://doi.org/10.1093/cid/cix753.CrossRefPubMed

131.

Chinula L, Brummel SS, Ziemba L, Stranix-Chibanda L, Coletti A, Krotje C, et al. Safety and efficacy of DTG vs EFG and TDF vs TAF in pregnancy: IMPAACT 2010 trial. Presented at: CROI 2020; 2020 march 8–11; Boston, Massachusetts. Available from: https://www.croiconference.org/abstract/safety-and-efficacy-of-dtg-vs-efv-and-tdf-vs-taf-in-pregnancy-impaact-2010-trial/. Accessed 11 July 2020.

Title: Non-communicable Diseases in Pregnant and Postpartum Women Living with HIV: Implications for Health Throughout the Life Course
Authors: Risa M. Hoffman
Caitlin Newhouse
Brian Chu
Jeffrey S. A. Stringer
Judith S. Currier
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Gestational Diabetes
Human Immunodeficiency Virus
Osteoporosis
Osteoporosis
Gestational Diabetes
Hypertension
Pre-Eclampsia
Dolutegravir
Hypertension
Published in: Current HIV/AIDS Reports / Issue 1/2021
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-020-00539-6

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Non-communicable Diseases in Pregnant and Postpartum Women Living with HIV: Implications for Health Throughout the Life Course

Abstract

Purpose of Review

Recent Findings

Summary

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 1/2021

Aging with HIV in Latin America and the Caribbean: a Systematic Review

Patient-Led Decision-Making for HIV Preexposure Prophylaxis

Gastrointestinal Dysfunction and HIV Comorbidities

Immune Dysregulation in Myocardial Fibrosis, Steatosis, and Heart Failure: Current Insights from HIV and the General Population

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page