The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy.

Wendy N Phoswa

doi:10.3389/fcvm.2021.613930

Abstract

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

Highlights

Human immune deficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is the major global health burden affecting ∼36.9 million people in the world, including 1.8 million children
The prevalence of human immune deficiency virus (HIV) infection is higher in low- and middle- income countries, with about 66% living in sub-Saharan Africa
“19.6 million people are living in East and Southern Africa” [2]

Summary

Introduction

Human immune deficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is the major global health burden affecting ∼36.9 million people in the world, including 1.8 million children. “About 25% people don’t know their HIV status” [1]. The prevalence of HIV infection is higher in low- and middle- income countries, with about 66% living in sub-Saharan Africa. “19.6 million people are living in East and Southern Africa” [2]. In 2017, there were 800,000 new HIV infections in 2017 in the Southern Africa. About 66% adults and 59% children are on anti-retroviral therapy [3]

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