Burns D N, Nourjah P, Minkoff H, Korelitz J, Biggar R J, Landesman S, Rubinstein A, Wright D, Nugent R P
Pediatric, Adolescent, and Maternal AIDS Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20892-7510, USA.
Am J Obstet Gynecol. 1996 May;174(5):1461-8. doi: 10.1016/s0002-9378(96)70589-6.
Our objective was to examine changes in CD4+ and CD8+ cell levels during pregnancy and post partum and to determine whether they differ for human immunodeficiency virus-1-seropositive and seronegative women.
A total of 192 human immunodeficiency virus-1-seropositive and 148 seronegative women enrolled in a study of mother-to-child transmission of human immunodeficiency virus-1 who had at least two lymphocyte subset measurements performed during pregnancy or post partum were included in this analysis. Mixed effects repeated-measures models were developed to examine changes in CD4+ and CD8+ cell levels during this period.
Consistent with prior reports that CD4+ cell levels decline during pregnancy and return to normal post partum, percent levels increased between the third trimester and 12 months post partum among human immunodeficiency virus-seronegative women (1.98%, p = 0.04). However, CD4+ levels declined steadily during pregnancy and post partum among seropositive women (-1.57%, p = 0.02 between the third trimester and 12 months post partum; =2.65%, p = 0.0004 between 2 and 24 months post partum). The percent CD8+ cell levels increased at or near delivery and declined to baseline between 2 and 6 months post partum in both seronegative and seropositive women, although only the declines were statistically significant in both groups (-2.66%, p = 0.004; and -2.02%, p = 0.02, respectively).
The percent CD4+ cell levels declined steadily during pregnancy and post partum among human immunodeficiency virus-seropositive women, indicating that human immunodeficiency virus disease continues to progress during this period. The percent CD8+ cell levels increased at or near delivery and declined to baseline post partum in both seronegative and seropositive women. These findings may have important clinical implications for both human immunodeficiency virus-infected and uninfected pregnant women.
我们的目的是研究孕期及产后CD4⁺和CD8⁺细胞水平的变化，并确定人类免疫缺陷病毒1型（HIV-1）血清阳性和血清阴性女性之间这些变化是否存在差异。
共有192例HIV-1血清阳性和148例血清阴性女性参与了一项关于HIV-1母婴传播的研究，这些女性在孕期或产后至少进行了两次淋巴细胞亚群测量，并纳入本分析。建立了混合效应重复测量模型来研究此期间CD4⁺和CD8⁺细胞水平的变化。
与先前报道一致，即CD4⁺细胞水平在孕期下降并在产后恢复正常，HIV血清阴性女性中，CD4⁺细胞百分比水平在孕晚期至产后12个月之间有所增加（1.98%，p = 0.04）。然而，血清阳性女性在孕期和产后CD4⁺水平持续下降（孕晚期至产后12个月之间为-1.57%，p = 0.02；产后2至24个月之间为-2.65%，p = 0.0004）。CD8⁺细胞百分比水平在血清阴性和血清阳性女性分娩时或接近分娩时均升高，并在产后2至6个月降至基线水平，尽管两组中只有下降具有统计学意义（分别为-2.66%，p = 0.004；和-2.02%，p = 0.02）。
HIV血清阳性女性在孕期和产后CD4⁺细胞百分比水平持续下降，表明在此期间HIV疾病持续进展。血清阴性和血清阳性女性的CD8⁺细胞百分比水平在分娩时或接近分娩时升高，并在产后降至基线水平。这些发现可能对HIV感染和未感染的孕妇均具有重要的临床意义。
