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HIV, Gestational Diabetes and TB in Pregnancy (PraGaTHi)
- The purpose of this study is to learn about how diabetes, TB, and HIV affect pregnant women and whether pregnancy, HIV and diabetes increase the risk of acquiring TB during pregnancy and postpartum.
- During pregnancy, some women will develop a form of diabetes (high blood sugar) called gestational diabetes (GDM) which could cause complications during pregnancy such as jaundice, high blood pressure, large baby, congenital anomalies in the baby, increased rate of caesarean and lead to a higher chance of diabetes after pregnancy. GDM also weakens the immune system, which is the body’s ability to respond to infections such as TB.
- TB is a serious infection that is very common in India. When a person is exposed to TB, they can become sick (active TB disease) or their body controls the infection and they do not become sick. The inactive form of TB remains in the body in sleeping mode and is known as latent TB. Latent TB can change to active TB when our immunity becomes low. Pregnant women are at higher risk of getting active TB because of changes in the body’s immune system (the system in a person’s body that helps fight infections) that happen during pregnancy naturally to keep the pregnancy continuing.
- The risk of a woman with HIV developing active TB is even higher because her immune system is weaker than a woman without HIV. Also, immune changes due to pregnancy might return to normal more slowly after delivery in women with HIV as compared to HIV-uninfected women, thus increasing the risk of developing TB even after delivery.
- We are studying how the risk of developing GDM may be different in pregnant women with and without HIV as well as whether GDM increases the risk of active TB.
- Understanding these associations in pregnant women is important because it will improve our ability to identify and treat women at high risk for GDM and active TB early and find ways to prevent complications in women and their babies.