Analysis of immunological markers associated with pregnancy and HIV-1 infection: relevance in perinatal transmission in HIV-1-infected pregnant women with low plasma viral load.
OBJECTIVE
In HIV-1-infected pregnant women with low plasma viral load, risk factors associated with perinatal HIV-1 transmission are not clearly understood.


METHODS
We analyzed distribution of peripheral CD8 T-cell subsets, plasma cytokines and measured secretory leukocyte peptidase inhibitor (SLPI) and myeloid-related protein (MRP)-8 levels in whole-blood and cervico-vaginal fluid (CVF) specimens obtained from 35 HIV-1-infected pregnant women (group 1), 12 HIV-1-infected non-pregnant women (group 2) and 15 HIV-1 uninfected pregnant women (group 3).


RESULTS
The group 1 women had higher expression of CD38, human leukocyte antigen-DR and CD95 on CD8 T-cells and higher levels of plasma tumor necrosis factor-alpha and epidermal growth factor. CVF-SLPI levels were the highest in group-3, while MRP-8 levels were the highest in group 1 women in plasma and CVF (P < 0.01). Although there were no cases of perinatal HIV-1 transmission, group 1 women undergoing HIV-1-indicated cesarean section had lower levels of CVF-SLPI as compared with those undergoing normal vaginal delivery.


CONCLUSIONS
Pregnancy contributes to the activation of peripheral CD8 T cells and increase in pro-inflammatory cytokines. Production of protective mucosal secretory factors such as SLPI is affected by HIV-1 infection in pregnant women and down-regulated SLPI levels may indirectly indicate a higher possibility of perinatal HIV-1 transmission.
Sachdeva
Naresh
N
University of Miami-Miller School of Medicine, 1550 NW 10th Avenue, Fox Building, Suite 118, Miami, FL 33136, USA.
Oshima
Kyoko
K
Cotter
Amanda
A
Ashman
Margarita
M
Davila
Leonardo
L
Okazaki
Takayuki
T
Inaba
Noriyuki
N
Asthana
Deshratn
D
D051997:ADP-ribosyl Cyclase 1 / Q000378:metabolism; D018528:ATP-Binding Cassette Transporters / Q000378:metabolism; D000328:Adult; D018106:CD28 Antigens / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000821:virology; D053481:Secretory Leukocyte Peptidase Inhibitor / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019562:Viral Load; D019014:fas Receptor / Q000378:metabolism
C435500:ABCC11 protein, human; D018528:ATP-Binding Cassette Transporters; D018106:CD28 Antigens; D006684:HLA-DR Antigens; C506814:SLPI protein, human; D053481:Secretory Leukocyte Peptidase Inhibitor; D014409:Tumor Necrosis Factor-alpha; D019014:fas Receptor; D051997:ADP-ribosyl Cyclase 1