HIV Infection in Pregnancy and the Risk of Gestational Hypertension and Preeclampsia

作     者：Beatrice Landi Valeria Bezzeccheri Brunella Guerra Mariangela Piemontese Francesca Cervi Lucia Cecchi Eleonora Margarito Stefano R. Giannubilo Andrea Ciavattini Andrea L. Tranquilli 

作者机构：Dipartimento di Scienze Cliniche Specialistiche Università Politecnica delle Marche Ancona Italy Dipartimento di Scienze Mediche e Chirurgiche Università di Bologna Bologna Italy Dipartimento Materno Infantile AOU OORR Ancona Salesi Hospital Ancona Italy 

出 版 物：《World Journal of Cardiovascular Diseases》 (心血管病（英文）)

年 卷 期：2014年第4卷第5期

页      面：257-267页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Human Immunodeficiency Virus Preeclampsia Gestational Hypertension African Ethnic Group Immune Tolerance 

摘      要：The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant group and in a HIV-negative control pregnant group matched for age and parity. Furthermore, we aimed to compare the rates of hypertensive disorders in a subgroup of HIV-positive and HIV-negative African-American Black women. Patients and Methods: This was a prospective observational cohort study conducted at two University Departments of Obstetrics and Gynecology, Salesi Hospital, Ancona, and Sant’Orsola Hospital, Bologna. The HIV-infected patients’ group consisted of 126 pregnant women;140 HIV-negative pregnant women matched for age and parity served as controls. Gestational hypertension and preeclampsia were diagnosed according to NHBPEP-ISSHP criteria. Categorical data were analyzed using the Fisher exact test. Statistical significance was set at a p value 0.05. Results: Gestational hypertension and preeclampsia were diagnosed in 3 of 126 HIV-positive patients (2.38%) and in 14 of 140 HIV-negative patients (10%), with a relative risk of 0.24 (p = 0.0112). In the subgroup of African-American Black women, gestational hypertension and preeclampsia were diagnosed in 2 out of 43 HIV-positive (4.7%) and in 3 out of 18 HIV-negative patients (16.7%) with a relative risk of 0.28, not statistically significant (p = 0.1887). Conclusion: Pregnant women with HIV infection seem to be protected against gestational hypertension and preeclampsia and this protective effect remains also in a high risk population, such as African-American Black ethnic group. The effect is present independently from treatment received and virus copies. The lack of immune response present since the conception period should account for unopposed trophoblast invasion resulting in a better placentation.