Department of Epidemiology, Columbia University Mailman School of Public Health.
Department of Medicine, Weill Cornell Medical College.
AIDS. 2021 Nov 15;35(14):2259-2268. doi: 10.1097/QAD.0000000000003016.
There are limited studies on the association of HIV infection with systemic inflammation during pregnancy.
A cohort study (N = 220) of pregnant women with HIV (N = 70) (all on antiretroviral therapy) and without HIV (N = 150) were enrolled from an antenatal clinic in Pune, India.
The following systemic inflammatory markers were measured in plasma samples using immunoassays: soluble CD163 (sCD163), soluble CD14 (sCD14), intestinal fatty acid-binding protein (I-FABP), C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP), interferon-β (IFNβ), interferon-γ (IFNγ), interleukin (IL)-1β, IL-6, IL-13, IL-17A, and tumor necrosis factor α (TNFα). Generalized estimating equation (GEE) and linear regression models were used to assess the association of HIV status with each inflammatory marker during pregnancy and by trimester, respectively.
Pregnant women with HIV had higher levels of markers for gut barrier dysfunction (I-FABP), monocyte activation (sCD14) and markers of systemic inflammation (IL-6 and TNFα), but surprisingly lower levels of AGP, an acute phase protein, compared with pregnant women without HIV, with some trimester-specific differences.
Our data show that women with HIV had higher levels of markers of gut barrier dysfunction, monocyte activation and systemic inflammation. These markers, some of which are associated with preterm birth, might help explain the increase in adverse birth outcomes in women with HIV and could suggest targets for potential interventions.
关于 HIV 感染与妊娠期间全身炎症的关联，相关研究有限。
本研究为在印度浦那的一家产前诊所招募的孕妇队列研究（N=220），包括 HIV 感染孕妇（n=70）（均接受抗逆转录病毒治疗）和未感染 HIV 的孕妇（n=150）。
使用免疫测定法测量血浆样本中的以下系统性炎症标志物：可溶性 CD163（sCD163）、可溶性 CD14（sCD14）、肠脂肪酸结合蛋白（I-FABP）、C 反应蛋白（CRP）、α1-酸性糖蛋白（AGP）、干扰素-β（IFNβ）、干扰素-γ（IFNγ）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-13（IL-13）、白细胞介素-17A（IL-17A）和肿瘤坏死因子-α（TNFα）。使用广义估计方程（GEE）和线性回归模型分别评估 HIV 状态与妊娠期间及各孕期的每个炎症标志物的关联。
与未感染 HIV 的孕妇相比，HIV 感染孕妇的肠道屏障功能标志物（I-FABP）、单核细胞激活标志物（sCD14）和全身炎症标志物（IL-6 和 TNFα）水平更高，但令人惊讶的是，急性相蛋白 AGP 水平更低，且存在一些孕期特异性差异。
我们的数据表明，HIV 感染女性的肠道屏障功能障碍、单核细胞激活和全身炎症标志物水平更高。这些标志物中的一些与早产有关，可能有助于解释 HIV 感染女性不良分娩结局增加的原因，并提示可能的干预靶点。
