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Inflammation Research

, Volume 68, Issue 1, pp 47–57 | Cite as

Pre-eclampsia: the role of highly active antiretroviral therapy and immune markers

  • Wendy N. PhoswaEmail author
  • Thajasvarie Naicker
  • Veron Ramsuran
  • Jagidesa Moodley
Review

Abstract

Purpose of the review

This review highlights the role immune cells and markers such as natural killer (NK) cells, cytokines and human leukocyte antigen (HLA-G) play in predisposing HIV-infected women who are on HAART to develop PE, thus contributing to a better understanding and early diagnosis of PE with a subsequent reduction in maternal foetal and neonatal deaths.

Recent findings

Pregnant women infected with the Human Immunodeficiency Virus (HIV) have a 25% risk of mother to child transmission. This risk, however, decreases to 2% if the women is on treatment. Highly active antiretroviral therapy (HAART) is the recommended treatment for both pregnant and non-pregnant women infected with HIV. Treatment with HAART is reported to potentiate predisposition to the development of hypertensive disorders of pregnancy such as pre-eclampsia (PE). Pre-eclampsia accounts for 7–10% of abnormal pregnancies worldwide. Studies demonstrate that pregnant women with HIV have PE at lower frequencies than uninfected women, however, the converse is observed upon HAART initiation. HIV-infected women on HAART exhibit a greater tendency to develop PE, emanating from immune reconstitution induced by HAART.

Summary

There is paucity of information as to the pathogenesis of PE upon HAART initiation and there are, therefore, controversial data as to whether HAART predisposes women to a lower, equal or higher risk of PE development compared to the general population, further investigations on the impact of HIV infection and HAART on the immune response and rate of PE development in HIV infected pregnant women are urgently needed.

Keywords

Highly active antiretroviral therapy Human immunodeficiency virus Immune markers Pre-eclampsia Pregnancy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Discipline of Obstetrics and Gynaecology, Nelson R Mandela School of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa
  2. 2.Optics and Imaging CentreUniversity of KwaZulu-NatalDurbanSouth Africa
  3. 3.KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical SciencesUniversity of KwaZulu-NatalDurbanSouth Africa
  4. 4.Centre for the AIDS Programme of Research in South Africa (CAPRISA)DurbanSouth Africa
  5. 5.Women’s Health and HIV Research GroupUniversity of KwaZulu-NatalDurbanSouth Africa

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