SERUM BILE ACID LEVEL IN PREGNANT WOMEN WITH AND WITHOUT HIV INFECTION

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Serum bile acid elevations during pregnancy are associated with obstetric cholestasis (OC), which carries significant risks of fetal demise and other complications. These are a consequence of bile acid-induced vascular placental insufficiency. OC is more common in patients with underlying liver disease (hepatitis C infection). HIV-infected women are subject to heptatotoxic agents that might increase the risk of OC. To determine if HIV-infected women have increased serum bile acid levels during pregnancy, we will compare serum bile acid levels during the 2nd and 3rd trimesters of pregnancy and in the cord blood of 40 HIV-infected, 10 Hep C-infected, and 10 uninfected pregnant women. We will identify associations between serum bile acid levels and birth conditions of the neonate. We will determine if antiretroviral medication affects bile acid levels by comparing the decrease between last month of pregnancy and post-partum in HIV-infected pregnant women who continue on therapy vs. other subjects. We will also conduct a retrospective study of OC at UCHSC to identify potential similarities between the clinical and biochemical findings associated with bile acid levels in HIV-infected pregnant women and the clinical, biochemical, and epidemiological characteristics of OC in normal pregnancy.