Author(s)

Beatrice Landi, Valeria Bezzeccheri, Brunella Guerra, Mariangela Piemontese, Francesca Cervi, Lucia Cecchi, Eleonora Margarito, Stefano R. Giannubilo, Andrea Ciavattini, Andrea L. Tranquilli

Dipartimento di Scienze Cliniche Specialistiche, Università Politecnica delle Marche, Ancona, Italy.
Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
Dipartimento Materno Infantile, AOU OORR Ancona, Salesi Hospital, Ancona, Italy.

The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant group and in a HIV-negative control pregnant group matched for age and parity. Furthermore, we aimed to compare the rates of hypertensive disorders in a subgroup of HIV-positive and HIV-negative African-American Black women. Patients and Methods: This was a prospective observational cohort study conducted at two University Departments of Obstetrics and Gynecology, Salesi Hospital, Ancona, and Sant’Orsola Hospital, Bologna. The HIV-infected patients’ group consisted of 126 pregnant women; 140 HIV-negative pregnant women matched for age and parity served as controls. Gestational hypertension and preeclampsia were diagnosed according to NHBPEP-ISSHP criteria. Categorical data were analyzed using the Fisher exact test. Statistical significance was set at a p value < 0.05. Results: Gestational hypertension and preeclampsia were diagnosed in 3 of 126 HIV-positive patients (2.38%) and in 14 of 140 HIV-negative patients (10%), with a relative risk of 0.24 (p = 0.0112). In the subgroup of African-American Black women, gestational hypertension and preeclampsia were diagnosed in 2 out of 43 HIV-positive (4.7%) and in 3 out of 18 HIV-negative patients (16.7%) with a relative risk of 0.28, not statistically significant (p = 0.1887). Conclusion: Pregnant women with HIV infection seem to be protected against gestational hypertension and preeclampsia and this protective effect remains also in a high risk population, such as African-American Black ethnic group. The effect is present independently from treatment received and virus copies. The lack of immune response present since the conception period should account for unopposed trophoblast invasion resulting in a better placentation.

Human Immunodeficiency Virus, Preeclampsia, Gestational Hypertension, African Ethnic Group, Immune Tolerance

Landi, B. , Bezzeccheri, V. , Guerra, B. , Piemontese, M. , Cervi, F. , Cecchi, L. , Margarito, E. , Giannubilo, S. , Ciavattini, A. and Tranquilli, A. (2014) HIV Infection in Pregnancy and the Risk of Gestational Hypertension and Preeclampsia. World Journal of Cardiovascular Diseases, 4, 257-267. doi: 10.4236/wjcd.2014.45034.