The impact of HIV and ART on the child during the prenatal period may be associated with the development of his obesity

According to a study presented on March 23, at ENDO 2019, the annual event of the Endocrine Society, adolescents and young people who, even before birth, were exposed to HIV and ART, but who have HIV-negative status, are at an increased risk of developing obesity and asthma

“These results show that all children of mothers living with HIV — most of whom are HIV-negative — should be closely monitored throughout their lives,” said lead researcher Dr. Lindsay T. Furman of the Massachusetts General Hospital in Boston.

Worldwide, over 1 million babies are born every year from mothers with HIV. With the advent of prenatal antiretroviral therapy designed to prevent HIV transmission during pregnancy, up to 98% of these babies may be infected but not infected (DPI). The long-term effects of exposure to HIV and antiretroviral therapy during pregnancy have not been carefully studied.

In view of this, in order to establish the details of the effect on young people, the study included 50 DPI (13–28 years old) and 141 people who did not experience this effect (vertical path), comparable in age, gender, race and ethnicity. Specialists found that obesity was reported in 42% of adolescents and young people with DPI, compared with 25% of their unexposed peers.

It was found that the prevalence of reactive respiratory diseases or those with asthma-like symptoms among young people with DPI is higher than that of their unexposed peers (40% versus 24%).

Researchers also examined maternal immune cell levels (CD4) during the last trimester of pregnancy. Lower prenatal maternal CD4 levels were associated with more severe HIV infection during pregnancy.

The results showed that a decrease in CD4 count in the third trimester was closely associated with an increase in body mass index (BMI) in adolescents with DPI.

“This suggests a biological relationship between the intrauterine environment in HIV and the long-term metabolic effects in the offspring,” said Dr. Furman.

“In a broader sense, this study adds more evidence that the intrauterine environment is an important but underestimated factor determining long-term metabolism. The results can lead to an understanding of the spread of obesity and metabolic diseases among other groups at increased risk of infection, including those born to mothers with obesity or diabetes, ”he said.

“As far as we know, this study includes the oldest cohort of DPI studied to date, and thus provides a long-term assessment of health complications among a population that continues to grow and age,” the specialist added.

“Our study is also the first to suggest that adolescents and young people with DPI may be at increased risk for obesity and metabolic diseases. Additional research is needed to further identify the unique metabolic risks associated with exposure to HIV in the womb. ”