CD4(-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION - EVIDENCE FOR PREGNANCY-INDUCED IMMUNE DEPRESSION IN UNINFECTED AND HIV-INFECTED WOMEN() LYMPHOCYTES IN PERINATAL HUMAN)

Immune function changes during pregnancy and human immunodeficiency vi rus (HIV) infection. T helper function and phenotypes in HIV-infected and -uninfected pregnant and postpartum women and nonpregnant uninfect ed control women were studied. T helper function was assessed by inter leukin-2 (IL-2) production in vitro and three-color flow cytometry. Al l uninfected nonpregnant subjects, 74% of uninfected pregnant subjects , and only 54% of HIV-infected pregnant subjects responded to all stim uli. All uninfected subjects 2-6 months postpartum had normal function versus 27% of infected subjects (trend P < .001). Uninfected pregnant subjects had reduced levels of CD4(+)CD45RA(-)RO(+) (memory) and elev ated levels of CD4(+)CD45RA(+)RO(-) (naive) lymphocytes. Infected preg nant subjects had elevated levels of memory, reduced levels of naive, and increased levels of CD4(+)HLA-DR(+)CD38(+) (activated) lymphocytes . Increased CD4(+)DR(+)CD38(+) cells correlated best with poor IL-2 fu nction, HIV infection, and being postpartum (R(2) = .79). Thus, T help er function and phenotypes are altered in pregnancy and return to base line postpartum in uninfected but not HIV-infected women.