Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa

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dc.contributor.advisorMalaba, Thokozile
dc.contributor.authorMore, Jessica
dc.date.accessioned2024-05-27T08:42:30Z
dc.date.available2024-05-27T08:42:30Z
dc.date.issued2023
dc.date.updated2024-05-22T08:18:27Z
dc.description.abstractBackground. High maternal body mass index (BMI) and the timing of antiretroviral (ART) initiation in pregnant women living with human immunodeficiency virus (HIV) (WLWH) may affect the controlled systemic inflammation during pregnancy. Proinflammatory immune markers during pregnancy and the impact of maternal BMI in WLWH initiating ART in pregnancy or preconception will be evaluated. Methods. In this mini-dissertation is a protocol (Part A), journal formatted manuscript (Part B) and Appendices (Part C) for a study on maternal BMI and inflammation in WLWH. A subset cohort from the Prematurity Immunology in HIV-infected Mothers and their infants Study (PIMS) study had three plasma immune markers (c-reactive protein (CRP), interferon-gamma inducible protein-10 (IP-10) and serum amyloid A (SAA)) and maternal weight measured from April 2015 to October 2016, at four antenatal care visits (visit 1, 2 (two weeks post-ART initiation in those initiating in pregnancy), 3 and 4). The association with maternal BMI by ART initiation (on ART preconception or initiated during current pregnancy) was assessed. Results. Among 526 pregnant WLWH, those on preconception ART had CRP and IP-10 levels lower compared to those who initiated ART in pregnancy. CRP was higher in obese WLWH (irrespective of timing of ART initiation) than those with a normal or overweight BMI. IP-10 was elevated in the 2nd trimester and SAA levels were highest in WLWH with a normal BMI. Conclusion. Immune marker level elevation is dependent on timing of ART exposure and pregnancy trimester. The timing of ART initiation and maternal BMI may adversely impact systemic inflammation in pregnant WLWH.
dc.identifier.apacitationMore, J. (2023). <i>Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/39706en_ZA
dc.identifier.chicagocitationMore, Jessica. <i>"Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023. http://hdl.handle.net/11427/39706en_ZA
dc.identifier.citationMore, J. 2023. Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/39706en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - More, Jessica AB - Background. High maternal body mass index (BMI) and the timing of antiretroviral (ART) initiation in pregnant women living with human immunodeficiency virus (HIV) (WLWH) may affect the controlled systemic inflammation during pregnancy. Proinflammatory immune markers during pregnancy and the impact of maternal BMI in WLWH initiating ART in pregnancy or preconception will be evaluated. Methods. In this mini-dissertation is a protocol (Part A), journal formatted manuscript (Part B) and Appendices (Part C) for a study on maternal BMI and inflammation in WLWH. A subset cohort from the Prematurity Immunology in HIV-infected Mothers and their infants Study (PIMS) study had three plasma immune markers (c-reactive protein (CRP), interferon-gamma inducible protein-10 (IP-10) and serum amyloid A (SAA)) and maternal weight measured from April 2015 to October 2016, at four antenatal care visits (visit 1, 2 (two weeks post-ART initiation in those initiating in pregnancy), 3 and 4). The association with maternal BMI by ART initiation (on ART preconception or initiated during current pregnancy) was assessed. Results. Among 526 pregnant WLWH, those on preconception ART had CRP and IP-10 levels lower compared to those who initiated ART in pregnancy. CRP was higher in obese WLWH (irrespective of timing of ART initiation) than those with a normal or overweight BMI. IP-10 was elevated in the 2nd trimester and SAA levels were highest in WLWH with a normal BMI. Conclusion. Immune marker level elevation is dependent on timing of ART exposure and pregnancy trimester. The timing of ART initiation and maternal BMI may adversely impact systemic inflammation in pregnant WLWH. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Epidemiology and Biostatistics LK - https://open.uct.ac.za PY - 2023 T1 - Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa TI - Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa UR - http://hdl.handle.net/11427/39706 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/39706
dc.identifier.vancouvercitationMore J. Maternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/39706en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectEpidemiology and Biostatistics
dc.titleMaternal body mass index and proinflammatory immune markers in HIV-infected pregnant woman on antiretroviral treatment in Cape Town, South Africa
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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