47-OR

Abstract

Objectives Contradicting evidence exists concerning the relationship between the human immunodeficiency virus (HIV), highly active antiretroviral therapy (HAART) and hypertensive disorders in pregnancy (HDP). This systematic review and meta-analysis aims to provide an overview and summary of the research hitherto. Methods A systematic review of EMBASE, PubMed and The Cochrane Library databases was conducted to obtain articles about the association between HIV in pregnancy and/or HAART and the risk of developing pregnancy-induced hypertension, pre-eclampsia or eclampsia. After title and abstract screening, full texts were obtained and using a standardized data extraction sheet, study characteristics and results were collected. Quality of articles was analyzed by using an adapted Cochrane Collaboration risk of bias assessment tool. Relative risks were pooled with a random-effects meta-analysis weighted by inverse variance. Results Of the 2136 articles screened, 26 studies were eligible for inclusion: fifteen on the association with PIH, fifteen on PE, five on eclampsia, and three articles about HAART regimens. All articles had a high risk of bias and between-study heterogeneity was considerable. Based on the meta-analysis, there does not seem to be an association between HIV and pregnancy-induced hypertension (RR 1.26, 95% CI 0.87–1.83, I2 = 78.6%,), preeclampsia (RR 1.04, 95%CI 0.88–1.21, I2 = 66.6%) or eclampsia (RR 1.61, 95% CI 0.14–18.68, I2 = 97.0%). A meta-analysis of the association with HAART treatment and risk of HDP could not be performed. Conclusions This systematic review and meta-analysis show no significant association between HIV positivity and/or HAART with PIH, PE or eclampsia. High risk of bias and between study heterogeneity limits the solidity of conclusions and well-designed studies are necessary to confirm or refute these findings. Disclosures J.L. Browne: None. V.J. Schrier: None. S.A. Peters: None. D.E. Grobbee: None. K. Klipstein-Grobusch: None.