Effects of pregnancy on endothelial function and cardiovascular disease risk in HIV-infected women

This study assessed flow-mediated vasodilation (FMD) and brachial artery diameter (BAD) in HIV-infected pregnant women compared to healthy pregnant controls, and determined their relationships to variables of interest, including the HIV status.

Subjects were enrolled prospectively for this longitudinal, observational study. Body mass index (BMI), blood pressure (BP), fasting lipoprotein profiles, homeostasis model assessment of insulin resistance (HOMA-IR), FMD, and BAD were assessed at 10-12, 20-22, and 32-35weeks gestation in HIV-infected women and healthy controls aged 18-45years with singleton pregnancies.

Fourteen HIV-infected women and 19 controls were enrolled. Groups were similar at baseline except there were more Caucasians in the control group (P<0.01). FMD and BAD did not change during pregnancy in either group, and there were no differences between groups. In multivariable regression analysis, FMD was associated with BAD (P=0.002), but not with age, BMI, BP, TC, TG, HOMA-IR, or HIV status. No variables were associated with BAD.

No differences were observed in FMD or BAD between HIV-infected and healthy pregnant women, and neither measure changed significantly during pregnancy. HIV status did not affect endothelial function or brachial artery diameter. Pregnancy does not appear to further increase the CVD risk associated with HIV infection.