Study explores pregnancy, obesity and HIV

More teenage boys need to be tested for HIV.
More teenage boys need to be tested for HIV.

A new birth cohort study to examine obesity in pregnant women living with HIV, as well as their children, has secured the University of Cape Town’s (UCT) division of epidemiology and biostatistics a R120 million grant from the United States National Institutes of Health (USNIH).

UCT joins an international consortium which includes Columbia University and Northwestern University in the United States of America (USA).

This study has been positioned in South Africa because of the high burden of both HIV and obesity, including during pregnancy. “This condition links together many non-communicable diseases, such as diabetes, hypertension and heart disease. Levels of obesity in adults and children in South Africa are increasing, presenting a major threat to public health over future decades,” said Professor Landon Myer, the head of the school of public health and family medicine (SPHFM) at UCT’s faculty of health sciences.

In many parts of SA, more than 20% of pregnant women are obese. Meanwhile, HIV’s burden on the country places it at the centre of that global epidemic, with a record 7.7 million people living with the virus. The prevalence of HIV in SA sits at 20.4% among people between 15 and 49 years old, according to a 2018 UNAIDS report.

The double threat of HIV and obesity facing many SA women is why UCT is collaborating on the obesogenic origins of maternal and child metabolic health involving dolutegravir (Orchid) study, which will follow approximately 1 800 women from early pregnancy through to their child’s second birthday.

Orchid seeks to investigate the drivers behind obesity in pregnant women living with HIV, as well as how the two conditions interact during pregnancy and through the postpartum period.

Follow-up visits will be conducted with the children as they grow up to understand the impact on their health of in-utero exposure to obesity.

The focus of Orchid will be on Cape Town’s Klipfontein-Mitchell’s Plain sub-district.

“We have been working with colleagues in Gugulethu, Mitchell’s Plain and nearby communities for more than a decade on maternal and child health research, and this work will build on that partnership,” said Myer.

Dr Hlengiwe Madlala, a co-investigator and Orchid project manager, recently documented the high levels of obesity in pregnant women in Cape Town.

Researchers found that while there is a high prevalence of HIV in pregnancy, the risk of obesity is not affected by HIV infection. This gives rise to critical and complicated questions around the implications of obesity and HIV when combined during pregnancy.

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