Immunosuppression in pregnant women infected with human immunodeficiency virus

Article Abstract:

Human immunodeficiency virus (HIV) causes a decrease in a type of white blood cell which fights infection, CD4+ (helper) T lymphocytes. Immunosuppression, the reduced ability to fight infection, depends on how long a person is infected with HIV and the number of helper T cells destroyed. The length of time it takes an HIV-infected person to develop a decrease in the number of immune cells depends upon the age and health status of the infected patient. In infants and hemophiliac adults this disease process progresses rapidly. During a normal pregnancy, the immune system is slightly compromised. The effect of HIV infection on the altered immune system of the mother is not known. The lymphocytes of 63 HIV-negative and 37 HIV-positive pregnant women at risk for HIV infection were studied. HIV-infected women demonstrated a decrease in CD4+ lymphocytes at a rate of two percent per month when compared with HIV-negative mothers. This decline was greater during pregnancy than after delivery. The decline was much faster in this patient population than in other high risk infected groups, such as homosexuals and hemophiliacs. The loss of these lymphocytes occurred in excess of the loss normally found during the end of the last trimester of pregnancy. Although none of the women in this study developed acquired immunodeficiency syndrome (AIDS), women in high risk groups should be aware that HIV infection during pregnancy speeds up the destruction of CD4+ lymphocytes, which may put these women at a particularly high risk for developing AIDS.

Research, Causes of, T cells, AIDS (Disease), Immunological tolerance, Immunologic tolerance, AIDS (Disease) in pregnancy, Virus-induced immunosuppression

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The relationship of the duration of ruptured membranes to vertical transmission of human immunodeficiency virus

Article Abstract:

The maternal CD4 count and the length of time to birth after rupture of membranes appear to play a role in whether HIV will be transmitted to the fetus. Researchers evaluated data on 191 HIV-positive mothers. Less than 5% were treated with zidovudine, a drug that reduces HIV transmission to the fetus. One-quarter of the infants were infected. Although transmission rates increased with duration of labor and the time from membrane rupture to delivery, the difference did not achieve statistical significance. However, among women with CD4 counts less than 20% of normal, those who delivered four hours or more after their membranes ruptured had a 4.5-fold increase in transmission rate compared with those who gave birth sooner. It seems likely that women with low CD4 counts would have a higher viral load in their bodily fluids.

Disease transmission, Fetal membranes

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The influence of pregnancy on human immunodeficiency virus type 1 infection: antepartum and postpartum changes in human immunodeficiency virus type 1 viral load

Article Abstract:

Pregnancy may not have a significant effect on the amount of virus in the blood of HIV-infected pregnant women. Pregnancy can alter immune function, which may have health implications for HIV-positive women. Researchers measured viral load in 160 HIV-positive pregnant women at several points during and after pregnancy. Only 44 women had taken any antiviral medication during the study. Generally, the load of the virus in the blood remained stable throughout pregnancy and in the first postpartum year, then rose in the second year after childbirth.

Viremia, Viral load

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