Sibiude JA, et al. - Researchers sought to determine the prevalence and risk factors of liver enzyme elevation (LEE) in a national prospective multicenter cohort of 5748 women receiving antiretroviral treatment (ART) during pregnancy. Observation revealed LEE (grade ≥ 1) in 16.7%, grade 3–4 in 2%. Among women with LEE, pre-eclampsia was reported in 6.7%, intrahepatic cholestasis of pregnancy in 9.8%, and other identified medical causes in 1.4%. No explanation could be provided for most LEEs (82.2%). Because of LEE, 51 (6%) women underwent hospitalization, 13 (2%) underwent cesarean section, 3 (0.4%) underwent induction of labor, and 49 (6%) women had change in ART regimen among women with unexplained LEE. Higher risk of preterm births was noted in correlation with unexplained LEE. Among women on ART at conception, lower risk of unexplained LEE was noted in those on NNRTI-based regimens than those on PI-based regimens. A PI-based regimen (89%)was reported in most women initiating ART during pregnancy. Among them, women on nelfinavir had less frequent LEE than those on lopinavir/r. LEE among pregnant women living with HIV influenceed obstetrical care management.