Ono Erika, Dos Santos Amélia M N, Machado Daisy M, Succi Regina C de M, Amed Abes M, Salomão Reinaldo, Kallás Esper G, de Moraes-Pinto M Isabel
Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
Cytometry B Clin Cytom. 2008 Jul;74(4):236-43. doi: 10.1002/cyto.b.20418.
The conjoint effect of HIV infection and pregnancy on the immune system of women submitted to the prophylactic antiretroviral therapy presently recommended is still poorly understood.
We evaluated 44 HIV-infected women (HIV) and 45 HIV-negative women (CT) at parturition and we compared them to 20 healthy nonpregnant women (NP). Immunophenotyping of lymphocytes was done by four-color flow cytometry.
All HIV-infected women received HAART during pregnancy and 56.8% had viral load <50 copies/mL at delivery. CD4+T cells/mm(3) were lower in HIV (447) than CT (593) and NP (738) (P < 0.05). CD8+T cells/mm(3) were higher in HIV (799) than CT (384) and NP (395) (P < 0.05). NK cells/mm(3) were lower in HIV (146) than in CT (253) and NP (198) (P < 0.05). CD38 expression on CD4+T and on CD8+T cells was higher in HIV (CD4:12.1; CD8:14.9) than in CT(CD4:9.2; CD8:10.2) and NP(CD4:8.6; CD8:6.0) (P < 0.05). However, CD56 expression on CD8+T cells (a marker of cytolytic effector function) was lower in HIV(7%) than in CT(12%) and NP(9%) (P < 0.05).
Even with low levels of viremia, HIV-infected women at delivery showed a different immunologic profile from both healthy non-HIV-infected women in the puerperium and nonpregnant women, with lower CD4+T and higher CD8+T cells, high levels of CD38 expression, but low CD56 expression on CD8+T cells and low NK cell numbers.
目前推荐的预防性抗逆转录病毒疗法对感染HIV的女性免疫系统以及怀孕对其免疫系统的联合影响仍知之甚少。
我们在分娩时评估了44名感染HIV的女性（HIV组）和45名未感染HIV的女性（CT组），并将她们与20名健康未怀孕女性（NP组）进行比较。通过四色流式细胞术对淋巴细胞进行免疫表型分析。
所有感染HIV的女性在孕期均接受了高效抗逆转录病毒治疗（HAART），56.8%的女性在分娩时病毒载量<50拷贝/毫升。HIV组的CD4+T细胞/立方毫米（447个）低于CT组（593个）和NP组（738个）（P<0.05）。HIV组的CD8+T细胞/立方毫米（799个）高于CT组（384个）和NP组（395个）（P<0.05）。HIV组的自然杀伤细胞（NK细胞）/立方毫米（146个）低于CT组（253个）和NP组（198个）（P<0.05）。HIV组CD4+T细胞和CD8+T细胞上CD38的表达（CD4：12.1；CD8：14.9）高于CT组（CD4：9.2；CD8：10.2）和NP组（CD4：8.6；CD8：6.0）（P<0.05）。然而，HIV组CD8+T细胞上CD56的表达（细胞溶解效应功能标志物）（7%）低于CT组（12%）和NP组（9%）（P<0.05）。
即使病毒血症水平较低，分娩时感染HIV的女性与健康未感染HIV的产后女性和未怀孕女性相比，仍表现出不同的免疫特征，即CD4+T细胞数量较低、CD8+T细胞数量较高、CD38表达水平较高，但CD8+T细胞上CD56表达较低且NK细胞数量较少。
