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Years: 2020 – 2021

Training Site: University of Zambia

Country: Zambia

Mentors: Jeffrey Stringer, MD; Bellington Vwalika, MD, MSc; Joni Price, MD, MSCR, MPH

Title: “Effect of maternal HIV infection on preeclampsia and associated biomarkers in Zambia”

Program Objectives:

Aim 1: To evaluate the association of maternal HIV infection and immune status on preeclampsia (PE). Hypothesis: HIV-infected women will have lower prevalence of PE than uninfected women overall, but this association will differ by immune status among those infected.

Aim 2: To quantify circulating levels of inflammatory cytokines (IL-2, IL-6, IL-10, TNF-α) and angiogenic factors (sEng, sFlt-1, PlGF) between HIV-infected and uninfected pregnant women with PE compared to non-PE controls and, among those infected, by CD4 cell count. Hypothesis: Among women with PE, anti-angiogenic markers will be lower and inflammatory cytokines higher among immunosuppressed HIV-infected women compared to both HIV-uninfected and infected but immune-competent women.

Aim 3: To assess whether (a) an elevated ratio of soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1:PlGF) is associated with prolonged inpatient postpartum stay among women with a diagnosis of PE and (b) this association differs by HIV serostatus and CD4 cell count. Hypothesis: Elevated sFlt:PlGF, associated with PE in previous studies, will predict prolonged inpatient postpartum stay among women with PE, however maternal HIV infection will weaken this association.


Bridget Spelke headshot