BACKGROUND: HIV-exposed uninfected (HEU) individuals are predisposed to adverse health outcomes, which in part may stem from the influence of an altered intrauterine milieu on fetal programming. The placenta serves as a readout for the effects of the maternal environment on the developing fetus and may itself contribute to the pathogenesis of disease. SETTING: US academic health system. METHODS: We leveraged a previously established registry-based cohort of HEU adolescents and young adults to identify 26 subjects for whom placental histopathology was available. We further obtained placental tissue from 29 HIV-unexposed pregnancies for comparison. We examined differences in placental histopathology between the groups and related villous vascularity in the HEU group to prenatal maternal characteristics and long-term health outcomes. RESULTS: Placentas from HEU pregnancies demonstrated a higher blood vessel count per villus as compared with controls (5.9 ± 1.0 vs. 5.4 ± 0.8; P = 0.05), which was independent of maternal prenatal age, race, body mass index, smoking status, hemoglobin, and gestational age. Furthermore, within the HEU group, lower CD4+ T-cell count during pregnancy was associated with greater placental vascularity (r = -0.44; P = 0.03). No significant relationships were observed between placental blood vessel count per villus and body mass index z-score or reactive airway disease among HEU individuals later in life. CONCLUSIONS: Placentas from HEU pregnancies demonstrated increased villous vascularity compared with HIV-unexposed controls in proportion to the severity of maternal immune dysfunction. Further studies are needed to examine intrauterine exposure to hypoxia as a potential mechanism of fetal programming in HIV.
BACKGROUND: HIV-exposed uninfected (HEU) individuals are predisposed to adverse health outcomes, which in part may stem from the influence of an altered intrauterine milieu on fetal programming. The placenta serves as a readout for the effects of the maternal environment on the developing fetus and may itself contribute to the pathogenesis of disease. SETTING: US academic health system. METHODS: We leveraged a previously established registry-based cohort of HEU adolescents and young adults to identify 26 subjects for whom placental histopathology was available. We further obtained placental tissue from 29 HIV-unexposed pregnancies for comparison. We examined differences in placental histopathology between the groups and related villous vascularity in the HEU group to prenatal maternal characteristics and long-term health outcomes. RESULTS: Placentas from HEU pregnancies demonstrated a higher blood vessel count per villus as compared with controls (5.9 ± 1.0 vs. 5.4 ± 0.8; P = 0.05), which was independent of maternal prenatal age, race, body mass index, smoking status, hemoglobin, and gestational age. Furthermore, within the HEU group, lower CD4+ T-cell count during pregnancy was associated with greater placental vascularity (r = -0.44; P = 0.03). No significant relationships were observed between placental blood vessel count per villus and body mass index z-score or reactive airway disease among HEU individuals later in life. CONCLUSIONS: Placentas from HEU pregnancies demonstrated increased villous vascularity compared with HIV-unexposed controls in proportion to the severity of maternal immune dysfunction. Further studies are needed to examine intrauterine exposure to hypoxia as a potential mechanism of fetal programming in HIV.
Authors: Claire von Mollendorf; Anne von Gottberg; Stefano Tempia; Susan Meiring; Linda de Gouveia; Vanessa Quan; Sarona Lengana; Theunis Avenant; Nicolette du Plessis; Brian Eley; Heather Finlayson; Gary Reubenson; Mamokgethi Moshe; Katherine L O'Brien; Keith P Klugman; Cynthia G Whitney; Cheryl Cohen Journal: Clin Infect Dis Date: 2015-02-02 Impact factor: 9.079
Authors: Christopher R Sudfeld; Quanhong Lei; Yvonne Chinyanga; Esther Tumbare; Nealia Khan; Fredrick Dapaah-Siakwan; Abia Sebaka; Jacinta Sibiya; Erik van Widenfelt; Roger L Shapiro; Joseph Makhema; Wafaie W Fawzi; Kathleen M Powis Journal: J Acquir Immune Defic Syndr Date: 2016-10-01 Impact factor: 3.731
Authors: Steven Nesheim; Allan Taylor; Margaret A Lampe; Peter H Kilmarx; Lauren Fitz Harris; Suzanne Whitmore; Judy Griffith; Melissa Thomas-Proctor; Kevin Fenton; Jonathan Mermin Journal: Pediatrics Date: 2012-09-03 Impact factor: 7.124
Authors: Clara Marincowitz; Amanda Genis; Nandu Goswami; Patrick De Boever; Tim S Nawrot; Hans Strijdom Journal: FEBS J Date: 2018-09-28 Impact factor: 5.542
Authors: Moses M Obimbo; Yan Zhou; Michael T McMaster; Craig R Cohen; Zahida Qureshi; John Ong'ech; Julius A Ogeng'o; Susan J Fisher Journal: J Acquir Immune Defic Syndr Date: 2019-01-01 Impact factor: 3.731