Term Pregnancy Woman with Human Immunodeficiency Virus Infection and Antiretroviral Therapy as Risk Factor of High Caspase-3 Expression in Placenta

Aim: To determine whether term pregnant women with human immunodeficiency virus infection who received antiretroviral therapy have a high Caspase-3 expression in the placenta. Methods: This cross-sectional analytical study was conducted at Sanglah General Hospital, Denpasar, and affiliated hospitals. Subjects were termed pregnant women with HIV (+) who received a minimum of six months of antiretroviral therapy as a risk group and pregnant women with HIV (-) as a non-risk group. Caspase-3 expression was assessed by immunohistochemical examination of placental tissue. The cut-off value for caspase-3 levels was determined by constructing a receiver operating characteristics (ROC) curve. The difference in proportion was assessed by the chi-square test, and the prevalence ratio (PR) was reported. The significance of this study was p<0.05. Results: Each 20 pregnant women were included in the risk and no-risk groups. There was no difference in age, gestational age, parity, and body mass index (BMI) between the two groups. The mean expression of caspase- 3 was significantly higher HIV (+) group than in the HIV (-) group (162.62 vs. 105.83; p = 0.000). The selected cut-off value of Caspase-3 was 127.05, with a sensitivity of 75% and a specificity of 75%. After classification, a significantly higher proportion of Caspase-3 expression was found in the HIV (+) group than in the HIV (-) group (75% vs. 25%; p=0.002). Pregnant women with HIV (+) and receiving antiretroviral therapy for a minimum of six months had a three times higher chance of having a high Caspase-3 prevalence than pregnant women who were not (RP=3.0; 95% CI = 1.348 – 6.678). Conclusion: Pregnant women with HIV infection who received antiretroviral therapy have a high Caspase-3 expression in the placenta. Keywords: Antiretroviral therapy, Caspase