Journal Article Review Ahead of print
PubMed: 42803644 DOI: 10.1080/14737159.2026.2741065
Integrated proteomics and metabolomics for predicting cardiometabolic risk in pregnant women living with HIV: current evidence and future directions.
Expert Rev Mol Diagn
Authors: Ahizechukwu C Eke, George U Eleje, Mahmoud U Sani, Ifeanyichukwu U Ezebialu, Faisal S Dankishiya, Ibrahim S Sodang, Ibrahim Y Ibrahim, C William Wester, Muktar H Aliyu, David R Graham
Affiliations
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
- Department of Internal Medicine, Bayero University/Aminu Kano University Teaching Hospital, Kano, Nigeria.
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria.
- Aminu Kano University Teaching Hospital, Kano, Nigeria.
- Department of Mathematical Science, Faculty of Physical Sciences, Bayero University Kano, Nigeria.
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- PREGNOMICS Study Team, Graham Scientific, Germantown, MD, USA.
Abstract
INTRODUCTION
Pregnant women living with HIV (PWLWH) experience cardiometabolic risk across pregnancy and postpartum, including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), dyslipidemia, obesity, and later metabolic disease. This heterogenous biology reflects gestational adaptation, HIV-associated immune adaptation, antiretroviral therapy (ART), placental function, and underlying cardiometabolic susceptibility. Integrated proteomic-metabolomic prediction studies in PWLWH remain scarce, positioning current evidence as a foundation for biomarker discovery and prospective validation.
AREAS COVERED
This review evaluates molecular and biomarker evidence from PWLWH alongside broader pregnancy literature informing proteomic and metabolomic discovery. Approaches include mass-spectrometry-based proteomics and metabolomics, affinity-based platforms including Olink and SomaScan, nuclear magnetic resonance, targeted assays, and multi-omics integration using regression, network, machine learning, and latent-factor methods. Emphasis is placed on inflammatory, endothelial, angiogenic, lipid, amino-acid, mitochondrial, and immune-metabolic pathways relevant to HDP, GDM, dyslipidemia, and postpartum cardiometabolic risk.
EXPERT OPINION
Integrated proteomics and metabolomics offer near-term value for mechanistic discovery and reproducible molecular risk signatures. Translation requires longitudinal cohorts, measured ART exposure, standardized pre-analytics, independent validation, and improvement beyond clinical risk factors. High burden settings additionally require resource-appropriate sampling, simplified targeted assays, local laboratory capacity, sustainable bioinformatics, demonstrable clinical utility, and scalable translational strategies.
MeSH
Diabetes Mellitus, Pregnant Women, Diabetes, Gestational, Hypertension, Pregnancy, Dyslipidemias, Biomarkers, Metabolomics, Proteomics, Postpartum Period