Dynamics of leukocyte telomere length in pregnant women living with HIV, and HIV-negative pregnant women: A longitudinal observational study

• Published in: PloS one Vol. 14; no. 3; p. e0212273
• Main Authors: Saberi, Sara, Kalloger, Steve E, Zhu, Mayanne M T, Sattha, Beheroze, Maan, Evelyn J, van Schalkwyk, Julianne, Money, Deborah M, Côté, Hélène C F
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.03.2019; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Aging; AIDS; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Biology and Life Sciences; Blood; Blood volume; Breastfeeding & lactation; Care and treatment; Cell division; Chromosomes; Control methods; Cross-Sectional Studies; Dosage and administration; Drug addiction; Drug therapy; Female; Gestation; Gynecology; Health aspects; Highly active antiretroviral therapy; HIV; HIV infections; HIV Infections - genetics; HIV patients; Hormones; Hospitals; Human immunodeficiency virus; Humans; Immune response; Infections; Inflammation; Laboratories; Leukocytes; Leukocytes - physiology; Longitudinal Studies; Medical research; Medicine; Medicine and Health Sciences; Multivariate Analysis; Observational studies; Obstetrics; Oxidative stress; Pathology; Pregnancy; Pregnant women; Premature birth; Prospective Studies; Protease inhibitors; Proteases; Proteinase inhibitors; Ritonavir; Smoking; Smoking - adverse effects; Smoking cessation; Social Sciences; Stem cells; Studies; Telomerase; Telomerase - genetics; Telomere - genetics; Telomere Shortening - genetics; Telomeres; Womens health; Young Adult; British Columbia Canada; Vancouver British Columbia Canada; Canada
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0212273

HIV-mediated inflammation and immune activation can accelerate telomere attrition. In addition, antiretrovirals can inhibit telomerase, possibly shortening telomeres. We examined the longitudinal dynamics of leukocyte telomere length (LTL) during pregnancy in a unique cohort of women living with HIV (WLWH) treated with combination antiretroviral therapy (cART), and HIV-negative control women. Blood was collected at three visits during pregnancy, at 13-23, >23-30, and >30-40 weeks of gestation, and for WLWH only, at 6 weeks post-partum. LTL was measured by qPCR and both cross-sectional and longitudinal (MANOVA) models were used to examine possible predictors of LTL among participants who attended all three visits during pregnancy. Among WLWH (n = 64) and HIV-negative women (n = 41), within participant LTL were correlated throughout pregnancy (p<0.001). LTL was shorter among WLWH at first visit, but this difference waned by the second visit. WLWH who discontinued cART post-partum experienced a decrease in LTL. Longitudinally, LTL was similar in both groups and increased as gestation progressed, a change that was more pronounced among women under 35 years. Among WLWH, both smoking throughout pregnancy (p = 0.04) and receiving a ritonavir-boosted protease inhibitor-based regimen (p = 0.03) were independently associated with shorter LTL. LTL increases as pregnancy progresses; the reasons for this are unknown but may relate to changes in blood volume, hormones, and/or cell subset distribution. While our observations need confirmation in an independent cohort, our data suggest that although some cART regimens may influence LTL, being on cART appears overall protective and that stopping cART post-partum may negatively impact LTL. The effect of smoking on LTL is clearly negative, stressing the importance of smoking cessation.