Decreased CD8 cell-mediated viral suppression and other immunologic characteristics of women who transmit human immunodeficiency virus to their infants.
CD8 T cell function, lymphocyte surface phenotype, serum markers of immunologic activation, and viral burden were assessed in 75 human immunodeficiency virus (HIV)-infected pregnant women, including 9 who transmitted infection to their infants. Serial studies during and after pregnancy showed no significant differences in levels of cell-surface or serum activation molecules in transmitting compared to nontransmitting mothers, with the exception of a postpartum increase in tumor necrosis factor alpha in transmitting women. The transmitting women had a median plasma viral load of 65,516 RNA copies/mL at delivery versus 5139 in nontransmitting women. During the third trimester, the CD8 cells of 81% of the nontransmitting and 44% of the transmitting mothers suppressed HIV production in vitro by >50%. Women with <50% suppression had a 3.4 times greater risk of transmitting HIV to their infants. CD8 suppression and viral load were interrelated, but when either CD4 percent or AZT use was controlled for, suppression was still significant.
Plaeger
S
S
Department of Pediatrics, UCLA School of Medicine, Los Angeles, CA 90095-1752, USA. splaeger@pediatrics.medsch.ucla.edu
Bermudez
S
S
Mikyas
Y
Y
Harawa
N
N
Dickover
R
R
Mark
D
D
Dillon
M
M
Bryson
Y J
YJ
Boyer
P J
PJ
Sinsheimer
J S
JS
D017252:CD3 Complex / Q000302:isolation & purification; D015704:CD4 Antigens / Q000302:isolation & purification; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D016655:HIV Core Protein p24 / Q000097:blood; D006679:HIV Seropositivity / Q000276:immunology* / Q000635:transmission* / Q000821:virology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D019798:Neopterin / Q000097:blood; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000276:immunology*; D012367:RNA, Viral / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D001613:beta 2-Microglobulin / Q000032:analysis
D017252:CD3 Complex; D015704:CD4 Antigens; D016655:HIV Core Protein p24; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha; D001613:beta 2-Microglobulin; D019798:Neopterin