MMP-9 is a key regulator of this process in normal pregnancy and dysregulated expression has been implicated in both pre-eclampsia and IUGR (Juanjuan Merchant et al., 2004; Świerczewski et al., 2012; Chen and Khalil, 2017; Ardiani et al., 2019), the former of which was rarely seen in PWLWH in the pre cART era (Wimalasundera et al., 2002). The gene discussed is MMP9; the disease is fetal growth restriction.