Early spontaneous abortions and fetal thymic abnormalities in maternal-to-fetal HIV infection.
The thymus is thought to play a major role in the immunopathogenesis of human immunodeficiency virus (HIV) infection, particularly in maternal-to-fetal HIV transmission. Characteristic lesions of the HIV-infected thymus include a prominent CD4+ CD8+ T lymphocyte depletion at the corticomedullary junction, the region of the thymus where immune selection occurs. At least threefold excess early spontaneous abortions were noted in a cohort of 124 HIV-infected pregnant women. In these 13 abortuses a very high rate (54%) of HIV vertical transmission was documented, with the thymus gland particularly affected. It is possible that the thymic insult in HIV-infected fetuses contributes to immune rejection of the fetus, possibly by an imbalance of maternal and fetal T1- and T2-type cytokines, known to be important in HIV disease progression. We propose, therefore, that the early spontaneous abortions occurring in HIV-infected pregnant women are due, at least in part, to abnormal immune forces created by HIV infection of the thymus.
Shearer
W T
WT
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Langston
C
C
Lewis
D E
DE
Pham
E L
EL
Hammill
H H
HH
Kozinetz
C A
CA
Kline
M W
MW
Hanson
I C
IC
Popek
E J
EJ
D000022:Abortion, Spontaneous / Q000209:etiology / Q000276:immunology*; D005260:Female; D005315:Fetal Diseases / Q000276:immunology* / Q000473:pathology; D005865:Gestational Age; D015658:HIV Infections / Q000276:immunology* / Q000473:pathology / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000473:pathology; D013950:Thymus Gland / Q000002:abnormalities* / Q000276:immunology* / Q000473:pathology