A systematic review of the effect of HIV infection and antiretroviral therapy on the risk of pre-eclampsia

BackgroundThe associations between HIV infection, antiretroviral therapy (ART), and pre-eclampsia are unclear.ObjectivesTo summarize research and clarify the implications of HIV and ART on pre-eclampsia risk.Search strategyMedLine, PubMed, Web of Science, and the Cochrane Library were searched for studies published between 2003 and July 2014, using relevant keywords.Selection criteriaFull-text review was dependent on the inclusion of pre-eclampsia as an outcome and original data.Data collection and analysisData for population, confounders, limitations, and measures of association were qualitatively assessed.Main resultsAmong 550 records identified, 70 were screened, and 13 were included. Five of the nine studies comparing pre-eclampsia risk between women with and without HIV infection found no significant difference; only one found that women living with HIV were more likely to experience pre-eclampsia. Two studies found that women living with HIV who were receiving ART at conception were more likely to experience pre-eclampsia than were those not receiving ART at conception. Two studies reported that pre-eclampsia rates did not differ by ART regimen.ConclusionsThere is insufficient evidence to conclude that women living with HIV and receiving ART have a higher risk of pre-eclampsia than do women without HIV infection; further research is needed to assess the association between ART and pre-eclampsia.