“CARMA-1-PREG: Placenta Mitochondrial Dysfunction and Preterm Birth “

Principal Investigator: Dr Deborah Money

Primary Contact: Evelyn Maan, Research Manager, 604-767-5044, emaan@cw.bc.ca

About the study: Anti-HIV drugs reduce the chance of HIV transmission from mother to child from 25% to less than 1%. It has been shown that some anti-HIV drugs, as an unwanted side effect, may have a toxic effect on the cells of the body. Some of the medications can have an effect on different body systems that leads to mitochondrial (energy-producing part of body cells) dysfunction. When the mitochondria are not working properly (mitochondrial toxicity) the body can start to build up high levels of lactate (a byproduct of cell function). Some doctors have expressed concerns that mitochondrial toxicity may be even more common in pregnant women than in other adults on these medications.

Preterm delivery is twice as common in women with HIV than women without and the precise cause is unknown.

The purpose of this project is to study the effect of taking anti-HIV drugs during pregnancy using two new laboratory tests. One will test the level of function of the mitochondria and the other test will look at damage drugs may do to the length of DNA at the end of chromosomes. Additionally, we aim to better understand factors that contribute to preterm delivery in HIV+ pregnancies.

Why is this research important?  Anti-HIV medication has dramatically reduced the risk of infants getting HIV from their HIV+ mothers (from 25% to less than 1%). However, research has demonstrated that HIV+ pregnant women are twice as likely to have a pre-term delivery when compared to women without HIV. Better understanding the factor(s) which cause these pre-term deliveries among HIV+ women is integral to the health of mothers and infants living with or exposed to HIV.

Study status: Recruiting at two sites – Vancouver and Montreal

Who can participate: Pregnant women living with HIV who are taking, or are going to be taking, anti-HIV medication during their pregnancy.

Recent Study Results/Publications: 

Saberi S, Kalloger SE, Zhu MMT, Sattha B, Maan EJ, van Schalkwyk J, Money DM, Côté HCF; CIHR Team in Cellular Aging and HIV Comorbidities in Women and Children (CARMA), “Dynamics of leukocyte telomere length in pregnant women living with HIV, and HIV-negative pregnant women: A longitudinal observational study”, PLoS One. 2019 Mar 6;14(3):e0212273. doi: 10.1371/journal.pone.0212273. eCollection 2019, PMID: 30840638

Ajaykumar A, Soudeyns H, Kakkar F, Brophy J, Bitnun A, Alimenti A, Albert AYK, Money DM, Côté HCF; CIHR Team in Cellular Aging and HIV Comorbidities in Women and Children; CIHR Team in Cellular Aging and HIV Comorbidities in Women and Children, “Leukocyte Telomere Length at Birth and During the Early Life of Children Exposed to but Uninfected With HIV After In Utero Exposure to Antiretrovirals”, J Infect Dis. 2018 Feb 14;217(5):710-720. doi: 10.1093/infdis/jix618, PMID: 29228317

Money DM, Wagner EC, Maan EJ, Chaworth-Musters T, Gadawski I, van Schalkwyk JE, Forbes JC, Burdge D, Albert AYK, Lohn Z, Côté HCF, and The Oak Tree Clinic Research Group “Evidence of subclinical mtDNA alterations in HIV-infected pregnant women receiving combination antiretroviral therapy compared to HIV-negative pregnant women”PLoS One. 2015 Aug 6;10(8):e0135041. doi: 10.1371/journal.pone.0135041. eCollection 2015.

Co-Investigators: Dr. Helene Cote, Dr. Julie van Schalkwyk, Dr. Isabelle Boucoiran, Dr. Chelsea Elwood, Dr Ariane Alimenti, Dr Wendy Robinson

Funded by: CIHR

Partners: None