title: Intrahepatic Cholestasis of Pregnancy and Serum Bile Acids in HIV-Infected Pregnant Women.
abstract: OBJECTIVE
  Intra-hepatic cholestasis of pregnancy (ICP) is uncommon, but has severe effects on pregnancy outcomes. ICP is characterized by elevated serum bile acids and liver enzymes and preferentially affects women with liver disorders. We compared bile acids and pregnancy outcomes of HIV-infected pregnant women, who commonly have elevated live enzymes, with uninfected controls.
  
  
  METHODS
  Twenty-four HIV-infected, including 2 co-infected with hepatitis C virus (HCV), and 25 uninfected women were tested during early and late pregnancy and postpartum.
  
  
  RESULTS
  After exclusion of the HCV-infected women, serum bile acids were similar in HIV-infected and uninfected participants. -glutamyl transpeptidase was elevated in HIV-infected compared with uninfected women during pregnancy and postpartum. Bilirubin and aspartate transaminase were higher in uninfected compared with HIV-infected women in early pregnancy, but subsequently similar. Bile acids in late pregnancy correlated with bile acids in the baby at birth. An HIV- and HCV-co-infected pregnant woman with active hepatitis developed ICP complicated by fetal distress. Another co-infected participant without active hepatitis had an uneventful pregnancy and delivery.
  
  
  CONCLUSIONS
  In the absence of HCV co-infection, bile acid metabolism appeared to be similar in HIV-infected and uninfected pregnant women. Both HIV-infected and uninfected pregnant women had mild liver enzyme elevations.
authors.affiliation: Department of Pediatrics, the University of Colorado School of Medicine, USA ; Department of Medicine, the University of Colorado School of Medicine, USA ; Department of Pathology, the University of Colorado School of Medicine, USA ; University of Colorado Hospital, USA ; Childrens Hospital Colorado, Aurora CO, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
authors.affiliation: Department of Preventative Medicine, the University of Colorado School of Medicine, USA ; Childrens Hospital Colorado, Aurora CO, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Allshouse
authors.affiliation: Department of Pediatrics, the University of Colorado School of Medicine, USA ; Childrens Hospital Colorado, Aurora CO, USA.
authors.forename: Kay
authors.initials: K
authors.lastname: Kinzie
authors.affiliation: Department of Pediatrics, the University of Colorado School of Medicine, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Cho
authors.affiliation: Departments of Obstetrics and Gynecology, the University of Colorado School of Medicine, USA ; University of Colorado Hospital, USA ; Denver Health Medical Center, Denver CO, USA.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Davies
authors.affiliation: Department of Pediatrics, the University of Colorado School of Medicine, USA ; Childrens Hospital Colorado, Aurora CO, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mc Farland
keywords: Antiretroviral Therapy; Bile acids; Hepatitis C virus; Human Immunodeficiency Virus; Intrahepatic cholestasis; Liver function; Pregnancy