IMMUNOLOGICAL ACTIVATION DURING PREGNANCY - SERIAL MEASUREMENT OF LYMPHOCYTE PHENOTYPE AND SERUM ACTIVATION MOLECULES IN HIV-INFECTED AND UNINFECTED WOMEN

Immunologic alterations occur during pregnancy, but the effect of preg nancy on HIV infection is controversial. We characterized some of the immunologic alterations with potential to influence HIV disease in 99 infected and 46 uninfected women during pregnancy and up to 6 months p ost-partum. Immunophenotyping to quantitate the major lymphocyte subse ts and determine expression of activation and adhesion molecules on T cells was performed using 3-color staining and laser flow cytometry. S erum neopterin, beta 2-microglobulin, and tumor necrosis factor-alpha (TNF alpha) were quantitated using commercial immunoassays. HIV+ pregn ant women were compared to uninfected pregnant subjects and to referen ce ranges established on healthy, HIV-seronegative non-pregnant female controls. Both CD4 and CD8 T cell subsets were increased in HIV-negat ive pregnant women compared to non-pregnant controls. In HIV-infected pregnant women, CD4 T cells were low and CD8 cells were elevated compa red to HIV-negative pregnant and non-pregnant women. Levels of subsets were stable during pregnancy and postpartum in both groups of women. Evidence of peripheral immune activation was found during the later st ages of pregnancy. Increases in HLA-DR and CD38 activation antigens on CD8 cells, serum neopterin and beta-2-microglobulin were seen during pregnancy in HIV-negative women. These correlates of immune activation were increased in HIV-infected pregnant women and increased further d uring pregnancy, paralleling changes seen in uninfected pregnant women . These immunologic alterations may directly or indirectly enhance vir al replication, impacting the long-term course of HIV disease. (C) 199 7 Elsevier Science Ireland Ltd.