title: Early spontaneous abortions and fetal thymic abnormalities in maternal-to-fetal HIV infection.
abstract: 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.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: W T
authors.initials: WT
authors.lastname: Shearer
authors.forename: C
authors.initials: C
authors.lastname: Langston
authors.forename: D E
authors.initials: DE
authors.lastname: Lewis
authors.forename: E L
authors.initials: EL
authors.lastname: Pham
authors.forename: H H
authors.initials: HH
authors.lastname: Hammill
authors.forename: C A
authors.initials: CA
authors.lastname: Kozinetz
authors.forename: M W
authors.initials: MW
authors.lastname: Kline
authors.forename: I C
authors.initials: IC
authors.lastname: Hanson
authors.forename: E J
authors.initials: EJ
authors.lastname: Popek
mesh_terms: 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