title: Metabolic alterations in HIV-infected pregnant women: moving to metabolic tailoring of antiretroviral drugs.
abstract: The most striking effect of increased survival and improved quality of life in HIV-infected women undergoing antiretroviral therapy is the feasibility of motherhood-desire satisfaction. However, such advantages are often associated with drug-related metabolic toxicities, particularly relevant in the pregnancy context. Recent guidelines provide recommendations and trends for the use of antiretroviral therapy in pregnant women, but current literature falls short of providing specific insights on the need for metabolic monitoring and treatment in HIV-infected pregnant women. In this review we provide specific insight into the state-of-the-art of: detection, evaluation, and management of metabolic alterations in this special population. Pregnancy is in fact a metabolic transition process, potentially associated with specific diseases in the mother, in the newborn, and in the adulthood of the child. We will not simply discuss antiretroviral therapy metabolic toxicities, but rather their interaction with the physiological metabolic changes occurring during pregnancy. Close monitoring is needed to diagnose metabolic alterations that can lead to adverse outcomes in the mother, in the newborn, and potentially in adulthood. Lifestyle interventions and an appropriate metabolic tailoring of antiretroviral therapy drugs need to be considered in the prevention and treatment of metabolic alteration during pregnancy.
authors.affiliation: Mother-Infant and Adult Department of Surgical and Medical Sciences, Clinic of Infectious Diseases, "Azienda Ospedaliero Universitaria Policlinico" of Modena, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Chiara
authors.initials: C
authors.lastname: Stentarelli
authors.forename: Anarita Domingues
authors.initials: AD
authors.lastname: Da Silva
authors.forename: Kety
authors.initials: K
authors.lastname: Luzi
authors.forename: Isabella
authors.initials: I
authors.lastname: Neri
authors.forename: Monica
authors.initials: M
authors.lastname: Cellini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Petrella
authors.forename: Elisa
authors.initials: E
authors.lastname: Garlassi
authors.forename: Marianna
authors.initials: M
authors.lastname: Menozzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchinetti
authors.forename: Cristina
authors.initials: C
authors.lastname: Mussini
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy
chemical_list: D019380:Anti-HIV Agents