Background: Despite the success of combination antiretroviral therapy (cART) for the prevention of
mother to child transmission of HIV, infants exposed to cART in utero frequently are born smaller and
have mild cardiac abnormalities. The mechanisms responsible for lower birth weight and cardiac abnormalities
in children exposed to cART are unclear but could be related to dysregulation of maternal
amino acid metabolism during pregnancy. Previous data in HIV() women have shown a relationship
between abnormal maternal protein metabolism during pregnancy and low infant birth weight and
animal data demonstrate a relationship between altered maternal protein metabolism and increased risk
for offspring cardiovascular abnormalities.