Research focuses on three areas: 1) characterization of drug transporter proteins and evaluation of protein function on the intracellular disposition of HIV-1 PIs in peripheral blood mononuclear cells between the maternal and fetal compartments; 2) evaluation of maternal, pregnancy and newborn outcomes following antepartum chemoprophylaxis in HIV-infected women; 3) pharmacokinetics/pharmacodynamics of ART in pregnancy; and 4) HIV-1 protease inhibitors induced placental cell injury; and 5) Strong efforts are made to characterize a variety of drug efflux transporter proteins and its function in the intracellular disposition of HIV-1 PIs in PBMCs between the mother and baby at the time of delivery.

Data on the safety of ART use and obstetrical management of ART-associated side effects during pregnancy remain limited. A database to monitor maternal, pregnancy, newborn outcomes study following antepartum ART chemoprophylaxis to reduce perinatal HIV-1 transmission has been established for patients referred to the HIV High Risk Pregnancy Program at the Ohio State University. Students will have opportunities to establish and maintain an outcomes database for HIV-infected pregnant women referred to the Erie County Medical Center (ECMC). Efforts will be made to merge the outcomes database between ECMC and OSU. The inter-university collaboration between OSU and the University at Buffalo (UB) will increase the outcomes data to better assess the efficacy and safety of ART use during pregnancy.

We recently reported a significant increase in the placental weight, placenta: newborn weight ratio, surface area, and thickness in dams despite a lack of difference in maternal plasma glucose. A similar trend was observed among HIV (+) women on a PI-containing antepartum regimen. These clinical findings support those observed in the experimental rat model and suggest a PI effect on the placenta that is glucose-independent. We are directing our research efforts on exploring PI-induced placental endothelial cell injury as a possible mechanism.