HIV-1 AND IMMUNOLOGICAL CHANGES DURING PREGNANCY - A COMPARISON BETWEEN HIV-1-SEROPOSITIVE AND HIV-1-SERONEGATIVE WOMEN IN NAIROBI, KENYA

Objective: To assess changes in the proportion of CD4 and CD8 T-lympho cyte profiles during pregnancy, at delivery and postpartum, and to det ermine whether HIV-1 infection affects the normal profile. Design and methods: A total of 416 pregnant HIV-1-infected women and an age and p arity-matched HIV-seronegative group of 407 pregnant women were enroll ed into a prospective study on the impact of HIV-1 infection on pregna ncy. Maternal blood was obtained for lymphocyte subset determination a t enrolment, delivery and 6 weeks postpartum. Whole blood sample drawn in EDTA-containing tubes were used to determine T-helper/inducer (CD4 ) and T-suppressor/cytotoxic (CD8) cells by direct immunofluorescence using monoclonal antibodies. Results: No relationship was found betwee n gestational age and any immunological variable. The CD4 percentage w as lower postpartum than antenatally, in both HIV-1-seropositive and s eronegative women, but this was not true for absolute CD4 counts. CD8 absolute counts and percentages were significantly higher postpartum t han antenatally. The differences between HIV-1-seropositive and serone gative women in changes over pregnancy in CD4 and CD8 cells and their ratio, were not statistically significant. Conclusion: Our findings do not support a short-term synergistic effect of HIV-1 and pregnancy on the immune function as determined by T-lymphocyte subsets.