Impact of HIV-1 infection on the IGF-1 axis and angiogenic factors in pregnant Cameroonian women receiving antiretroviral therapy

Although mother-to-child transmission of HIV has dramatically declined, the number of in utero HIV-exposed, uninfected infants is on the increase. HIV-exposed infants are at an increased risk of mortality, morbidity and slower early growth than their non-HIV exposed counterparts. Maternal HIV increa...

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Published in:	PloS one Vol. 14; no. 5; p. e0215825
Main Authors:	Esemu, Livo F, Yuosembom, Emile K, Fang, Rui, Rasay, Shayne, Fodjo, Barriere A Y, Nguasong, John T, Kidima, Winifrida, Ekali, Gabriel L, Chen, John J, Ndhlovu, Lishomwa, Bigoga, Jude D, Taylor, Diane W, Leke, Rose G F, Babakhanyan, Anna
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 01-05-2019 Public Library of Science (PLoS)
Subjects:	Adult Analysis Angiogenesis Angiopoietins - blood Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Babies Binding proteins Biochemistry Bioindicators Biological markers Biology and Life Sciences Biomarkers Biomarkers - blood Biotechnology Birth weight Cameroon CD4 antigen Cross-Sectional Studies Cytokines Disease transmission Dosage and administration Drug therapy EDTA Efavirenz Exposure Female Fetal development Fetuses Gelatinase A Gelatinase B Growth factors Health aspects Health risks Herbal medicine Highly active antiretroviral therapy HIV HIV infections HIV Infections - complications HIV Infections - drug therapy HIV Infections - metabolism HIV patients Human immunodeficiency virus Humans Infants Infections Insulin Insulin-Like Growth Factor Binding Protein 1 - analysis Insulin-Like Growth Factor Binding Protein 1 - blood Insulin-like growth factor I Insulin-Like Growth Factor I - analysis Insulin-Like Growth Factor I - metabolism Insulin-like growth factor-binding protein 1 Insulin-like growth factor-binding protein 3 Insulin-like growth factors Low-birth-weight Malaria Malaria - complications Malaria - diagnosis Matrix metalloproteinase Matrix Metalloproteinase 9 - blood Matrix metalloproteinases Medical research Medicine Medicine and Health Sciences Morbidity Mortality Mother-child relations Pharmacology Placenta Placenta - metabolism Placenta - pathology Preeclampsia Pregnancy Pregnant women Protein binding Proteins Pyrimethamine Regression analysis Regression models Risk factors Therapy Vector-borne diseases Veins & arteries Women Women's health Young Adult Cameroon Hawaii United States > US
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Summary:	Although mother-to-child transmission of HIV has dramatically declined, the number of in utero HIV-exposed, uninfected infants is on the increase. HIV-exposed infants are at an increased risk of mortality, morbidity and slower early growth than their non-HIV exposed counterparts. Maternal HIV increases the risk of having preterm deliveries, intrauterine growth restriction and low birth weight babies. However, the mechanism underlying dysregulation of fetal growth in HIV-infected pregnant women is unknown. We sought to determine whether maternal HIV is associated with dysregulation of the insulin-like growth factor (IGF) axis, some angiogenic factors or other related biomarkers that regulate fetal growth. A total of 102 normotensive pregnant women were enrolled in a small cross-sectional study. Amongst these were thirty-one HIV-1 positive women receiving combination antiretroviral therapy (cART) (Mean age: 30.0 ± 5.1 years; % on ART: 83.9%; median plasma viral load: 683 copies/ml; median CD4 count: 350 cells/ul) and 71 HIV uninfected women (mean age: 27.3 ± 5.8) recruited at delivery. A panel of biomarkers including IGF1 and IGF binding proteins (IGFBP1, IGFBP3), angiopoietins (ANG) 1 and 2, matrix metalloproteinases (MMP) 2 and 9, and galectin 13, was measured in plasma collected from the placental intervillous space. The levels of IGF1, IGFBP1, ANG1, ANG2, MMP2, MMP9 and Gal-13 were not affected by maternal HIV, even when adjusted for maternal factors in linear regression models (all p>0.05). It was observed that HIV-infection in pregnancy did not significantly affect key markers of the IGF axis and angiogenic factors. If anything, it did not affect women. These findings highlight the importance of the use of ART during pregnancy, which maintains factors necessary for fetal development closer to those of healthy women. However, decrease in IGF1 levels might be exacerbated in women con-infected with HIV and malaria.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0215825