Saha Aparajita, Escudero Jaclyn N, Layouni Troy, Mecha Jerphason, Maleche-Obimbo Elizabeth, Matemo Daniel, Kinuthia John, John-Stewart Grace, Richardson Barbra A, LaCourse Sylvia M, Shah Javeed A
Department of Medicine, University of Washington, Seattle, Washington, USA.
Institute of Public Health Genetics, University of Washington, Seattle, Washington, USA.
Open Forum Infect Dis. 2025 Feb 5;12(2):ofaf067. doi: 10.1093/ofid/ofaf067. eCollection 2025 Feb.
Pregnancy increases (Mtb) reactivation risk and alters immune responses. We assessed Mtb-specific CD4+ T-cell responses in pregnant women with HIV (WLHIV) and without, including those receiving isoniazid preventive therapy (IPT).
We measured adaptive immune responses from 33 participants (HIV+ 21, HIV- 12) with positive interferon-gamma release assay during pregnancy (20-34 weeks' gestation), 6 weeks, and 12 months postpartum by intracellular cytokine staining. We measured overall responses using COMPASS and made comparisons by nonparametric analysis of variance.
We observed diminished Mtb-specific CD4+ T-cell responses in WLHIV during pregnancy versus 12 months postpartum (COMPASS median functional score [FS] .009 vs 0.12, = .03). WLHIV who received IPT (n = 8) during concurrent pregnancy had attenuated Mtb-specific CD4+ T-cell responses during pregnancy versus 12 months postpartum (median FS 8.3 × 10 vs 0.13, = .02), but WLHIV who did not receive IPT during pregnancy had similar responses in pregnancy and postpartum. Mtb-specific CD8+ FS was increased postpartum in all groups. We found preexisting Mtb-specific CD4+ T-cell responses in participants who converted interferon-gamma release assay tests postpartum (n = 10).
Pregnant WLHIV, especially those on IPT, showed reduced Mtb-specific CD4+ T-cell responses. Understanding the impact of pregnancy on Mtb-specific T-cell responses may improve diagnostic approaches.
妊娠会增加结核分枝杆菌（Mtb）重新激活的风险并改变免疫反应。我们评估了感染HIV的孕妇（WLHIV）和未感染HIV的孕妇中Mtb特异性CD4+ T细胞反应，包括接受异烟肼预防性治疗（IPT）的孕妇。
我们通过细胞内细胞因子染色，测量了33名参与者（21名HIV阳性，12名HIV阴性）在孕期（妊娠20 - 34周）、产后6周和12个月时，干扰素-γ释放试验呈阳性的适应性免疫反应。我们使用COMPASS测量总体反应，并通过非参数方差分析进行比较。
我们观察到，与产后12个月相比，WLHIV在孕期的Mtb特异性CD4+ T细胞反应减弱（COMPASS中位功能评分[FS].009对0.12，P = 0.03）。同时接受IPT（n = 8）的WLHIV在孕期的Mtb特异性CD4+ T细胞反应与产后12个月相比减弱（中位FS 8.3×10对0.13，P = 0.02），但孕期未接受IPT的WLHIV在孕期和产后的反应相似。所有组中，产后Mtb特异性CD8+ FS均增加。我们在产后干扰素-γ释放试验结果转换的参与者（n = 10）中发现了预先存在的Mtb特异性CD4+ T细胞反应。
妊娠的WLHIV，尤其是接受IPT的患者，Mtb特异性CD4+ T细胞反应降低。了解妊娠对Mtb特异性T细胞反应的影响可能会改善诊断方法。
