title: Pro-Inflammatory Cytokine Levels in HIV Infected and Uninfected Pregnant Women with and without Preeclampsia.
abstract: BACKGROUND
  Preeclampsia and HIV/AIDS are inflammatory conditions that contribute significantly to adverse maternal and foetal outcomes. The immune reconstitution effects of HAART on inflammatory mediators has not been adequately studied in pregnancy and may impact on the inflammatory cytokine network in women with co-morbid preeclampsia. Our study evaluated changes in pro-inflammatory cytokines IL-2, TNF-α, IFN-γ and IL-6 in HIV infected preeclamptic women on HAART.
  
  
  METHODS
  A prospective experimental study was conducted at Prince Mshiyeni Memorial Hospital between July 2013 and September 2014. One hundred and ninety three pregnant women were recruited into 4 groups: uninfected normotensive (50; 26%), infected normotensive (45; 23%), uninfected preeclamptic (53; 28%) and infected preeclamptic women (45; 23%). Serum levels of cytokines TNF-α, IFN- γ, IL-2 and IL-6 were determined using commercially available kits and a Cytometric Bead Array (CBA). Comparative data was recorded and analysed descriptively.
  
  
  RESULTS
  In the control groups (normotensive), significantly lower values were found in IL-2 (p = 0.010), TNF-α (p = 0.045), and IL-6 (p = 0.005); and a non-significant decrease was observed in IFN-γ (p = 0.345) in HIV infected women on HAART compared to uninfected controls. In the experimental group (preeclamptic) women, significantly reduced levels were observed in IL-2 and TNF-α (p = 0.001; p = 0.000) and non-significant decreases were observed in IFN-γ and IL-6 (p = 0.023; p = 0.086) in HIV infected women on HAART compared with uninfected preeclamptic women. Non-significant differences were observed between uninfected preeclamptic and normotensive women.
  
  
  CONCLUSIONS
  In uncomplicated/normotensive pregnancies, HIV/HAART is associated with significant decreases in IL-2, TNF-α and IL-6, and in preeclamptic women significant decreases in IL-2 and TNF-α were observed. These findings suggest that HIV/HAART impacts on pro-inflammatory cytokines in women with co-morbid preeclampsia. This provides a platform for further research on immune reconstitution effects of HAART during pregnancy, and the development of potential immune modulation therapies for the management of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.|Discipline of Medical Biochemistry, College of Health Sciences, University of KwaZulu-Natal, South Africa.
authors.forename: Niren Ray
authors.initials: NR
authors.lastname: Maharaj
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.
authors.forename: Alisa
authors.initials: A
authors.lastname: Phulukdaree
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.
authors.forename: Savania
authors.initials: S
authors.lastname: Nagiah
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.
authors.forename: Prithiksha
authors.initials: P
authors.lastname: Ramkaran
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.
authors.forename: Charlette
authors.initials: C
authors.lastname: Tiloke
authors.affiliation: Department of Obstetrics and Gynaecology, Prince Mshiyeni Memorial Hospital, KwaZulu-Natal, South Africa.
authors.forename: Anil Amichund
authors.initials: AA
authors.lastname: Chuturgoon
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007376:Interleukin-2 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha