Key result
Peripartum antiretroviral therapy impairs postpartum cardiac reverse remodeling in rats.
Why the study?
It remains unclear whether increased maternal cardiovascular risk in women living with HIV is driven by chronic viremia or antiretroviral therapy (ART), specifically NRTI-containing regimens that affect mitochondria.
Does peripartum exposure to combination antiretroviral therapy impair postpartum cardiac reverse remodeling in a rodent model?
Does peripartum exposure to combination antiretroviral therapy impair postpartum cardiac reverse remodeling in a rodent model?
Peripartum exposure to NRTI-containing antiretroviral therapy impairs postpartum cardiac reverse remodeling and alters mitochondrial metabolism in a rodent model, suggesting potential long-term cardiovascular risks.
NRTI-ART may impair postpartum cardiac remodeling; rat findings leave open relevance for women with HIV.
Cardiovascular (CV) disease is the leading cause of maternal mortality worldwide and has been partially linked to the cardiometabolic remodeling required to support fetal growth. In healthy pregnancies, these adaptations reverse postpartum without long-term consequences; however, impaired reverse remodeling (RR) increases future CV risk. Pregnant women living with HIV face additional risk, though it remains unclear whether this is driven by chronic low-level viremia or continuous antiretroviral therapy (ART). ART used during pregnancy often includes nucleoside reverse transcriptase inhibitors (NRTIs), which can affect mitochondria - organelles essential for maintaining cardiac function. Here, we tested the hypothesis that NRTI-containing ART negatively impacts the maternal heart. Using a rat model, we show that ART impairs pregnancy-associated cardiac RR. Mechanistically, ART induced mitochondrial alterations in both the heart and the liver, leading to dyslipidemia that collectively compromised cardiac function. These findings emphasize the importance of maternal cardiovascular health research and the need for further studies on the long-term effects of ART.
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Taube et al. (2026) studied Pregnancy-associated cardiac reverse remodeling. Combination antiretroviral therapy (abacavir, dolutegravir, lamivudine) vs. Vehicle control was evaluated on Cardiac reverse remodeling and mitochondrial function. Continuous exposure to nucleoside reverse transcriptase inhibitor-containing antiretroviral therapy during the peripartum period impaired post-pregnancy cardiac reverse remodeling in a rat model.
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