Brief Report: Inflammatory Markers in Pregnancy Are Associated With Postpartum Weight in South African Women Living With HIV on Antiretroviral Therapy.

Supplemental Digital Content is Available in the Text. Background: Postpartum weight (PPW) contributes to long-term obesity, a growing concern in persons with HIV (PWHs). We investigated whether inflammatory markers in pregnancy may be involved in postpartum (PP) obesity in PWHs. Setting: A total of 57 pregnant PWHs enrolled at ≤14 weeks gestation (T1) in Gugulethu antenatal care clinic in Cape Town and followed through 48 weeks PP were included. Methods: Plasma soluble (s) CD14, sCD163, leptin, tumor necrosis factor receptor 1, resistin, adiponectin, and interleukin-6 (IL-6) were assayed in duplicate using the Luminex platform. We considered each inflammatory marker at T1 (n = 57) and T3 (29–36 weeks gestation, n = 31) as a separate exposure of interest. Linear mixed-effects models were fit to examine whether each exposure was associated with average PPW and PPW trajectories; linear regression was used for associations with PPW change between T1 and 48 weeks. Results: The median age was 32 years (interquartile range [IQR], 29–35), 98% were multigravida, and 49% had a BMI ≥30 kg/m2. Higher T1 sCD14 levels were associated with higher average weight through 48 weeks PP (ß = 0.002, P = 0.04) and T3 sCD14 with higher PPW gain (ß = 0.007, P = 0.04). Leptin (ß = 0.414, P < 0.01), tumor necrosis factor receptor 1 (ß = 11.048, P < 0.01), and resistin (ß = 0.714, P = 0.01) at T3 were associated with higher average PPW and IL-6 (ß = 2.266, P = 0.02) with PPW gain. Conclusions: These findings suggest that low-grade inflammation in pregnancy may play a role in PP obesity, pointing to potential mechanisms with implications for long-term cardiometabolic health in PWH. [ABSTRACT FROM AUTHOR]