Does HAART dysregulate angiogenesis in HIV infected preeclampsia?

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Cardiovascular Biology

Background:

• Angiogenic mediator dysregulation is linked to HIV infection.
• Data on highly active antiretroviral therapy (HAART) in pregnancy and preeclampsia (PE) is inconsistent.
• South Africa has high prevalence rates of HIV and PE.

Purpose of the Study:

• To determine placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) levels in HIV-infected pregnancies with and without PE, treated with HAART.
• To investigate the impact of HAART on angiogenic mediators in HIV-infected pregnant individuals.

Main Methods:

• Serum samples were collected from HIV-positive and HIV-negative pregnant individuals, categorized as normotensive or preeclamptic.
• PlGF and sFlt-1 levels were quantified using Milliplex Multiplex immunoassay.
• Statistical analysis was performed to compare mediator levels across groups.

Main Results:

• Soluble fms-like tyrosine kinase-1 (sFlt-1) was significantly upregulated in preeclamptic HIV-positive (P+) compared to normotensive HIV-positive (N+) pregnancies.
• Placental growth factor (PlGF) was significantly downregulated in preeclamptic pregnancies regardless of HIV status.
• The sFlt-1/PlGF ratio was significantly increased in preeclamptic HIV-negative (P-) compared to normotensive HIV-negative (N-) pregnancies.
• An amplification of sFlt-1 with concurrent PlGF downregulation was observed in HIV-infected pregnancies receiving HAART.

Conclusions:

• Preeclampsia is associated with altered angiogenic mediator profiles, specifically increased sFlt-1 and decreased PlGF.
• HIV-infected pregnancies on HAART exhibit an amplified sFlt-1 response relative to PlGF.
• These findings highlight potential interactions between HAART, HIV, and angiogenic dysregulation in the context of preeclampsia.