Brettle R P, Raab G M, Ross A, Fielding K L, Gore S M, Bird A G
Regional Infectious Disease Unit, City Hospital, Scotland, UK.
AIDS. 1995 Oct;9(10):1177-84.
To describe the influence of pregnancy on immunological marker paths and progression of HIV-infected women.
Analysis of prospectively collected immunological and clinical data collected on 145 women reviewed at the City Hospital, Edinburgh, between 1985 and 1992 using a two-level random-effects model that allows for within- and between-patient variance.
There were differences between the marker paths of women according to risk activity; women who had acquired HIV via injecting drug use (in addition to heterosexual intercourse) had a higher level of absolute CD4 cells, CD4% and total lymphocytes at seroconversion than those who had acquired HIV via heterosexual intercourse alone; however, immunological markers declined more steeply after seroconversion. There was no evidence that pregnancy, either before or after HIV seroconversion had an adverse effect on marker paths of HIV disease. There was a significant association between pregnancy after HIV seroconversion and post-pregnancy changes in immunological markers: an increase in the CD4% and a decrease in CD8%. However, causality cannot be implied as pregnancy itself may be associated with considerable lifestyle changes. During pregnancy the total white blood count rose due to an increase in the number of granulocytes, whereas the total lymphocyte numbers fell. The absolute CD4 lymphocyte subset counts fell progressively but the effect was due to the fall in the total lymphocyte counts, there being no influence of pregnancy on either CD4% or CD8%.
In asymptomatic HIV infection, changes in the absolute levels of CD4 and CD8 lymphocyte counts are primarily related to changes in the other components of the white cell count because there were no changes in CD4% and CD8%. Pregnancy itself has no adverse effect on immunological markers of HIV.
描述妊娠对感染人类免疫缺陷病毒（HIV）女性的免疫标志物途径及病情进展的影响。
对1985年至1992年间在爱丁堡市医院接受检查的145名女性前瞻性收集的免疫和临床数据进行分析，采用二级随机效应模型，该模型考虑了患者内和患者间的差异。
根据风险活动，女性的标志物途径存在差异；通过注射毒品（除异性性行为外）感染HIV的女性在血清转化时的绝对CD4细胞、CD4%和总淋巴细胞水平高于仅通过异性性行为感染HIV的女性；然而，血清转化后免疫标志物下降更为陡峭。没有证据表明在HIV血清转化之前或之后的妊娠会对HIV疾病的标志物途径产生不利影响。HIV血清转化后的妊娠与妊娠后免疫标志物的变化之间存在显著关联：CD4%增加，CD8%减少。然而，由于妊娠本身可能与相当大的生活方式改变有关，因此不能暗示存在因果关系。在妊娠期间，由于粒细胞数量增加，白细胞总数上升，而总淋巴细胞数量下降。绝对CD4淋巴细胞亚群计数逐渐下降，但这种影响是由于总淋巴细胞计数下降所致，妊娠对CD4%或CD8%均无影响。
在无症状HIV感染中，CD4和CD8淋巴细胞计数的绝对水平变化主要与白细胞计数其他成分的变化有关，因为CD4%和CD8%没有变化。妊娠本身对HIV的免疫标志物没有不利影响。
