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

Background: The associations between HIV infection, antiretroviral therapy (ART), and pre-eclampsia are unclear. Objectives: To summarize research and clarify the implications of HIV and ART on pre-eclampsia risk. Search strategy: MedLine, PubMed, Web of Science, and the Cochrane Library were searched for studies published between 2003 and July 2014, using relevant keywords. Selection criteria: Full-text review was dependent on the inclusion of pre-eclampsia as an outcome and original data. Data collection and analysis: Data for population, confounders, limitations, and measures of association were qualitatively assessed. Main results: Among 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. Conclusions: There 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. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.