Objective

To determine the cytokine profile of HIV infected women treated with highly active anti-retroviral therapy (HAART) of variable duration in pregnancy.

Methods

HIV infected women were enrolled at a large tertiary hospital in Durban, South Africa in their antenatal period and stratified into those that initiated HAART before pregnancy (pre-pregnancy HAART or PPH group) and those who initiated HAART during pregnancy (in-pregnancy HAART or IPH group). These were compared with HIV negative women (HN group), matched for gestational age at the time of enrolment. Serum was obtained and Th1 and Th2 cytokines expression determined using the Bio-Plex Pro™ Human Cytokine Treg Panels.

Results

The overall cytokine profile of the cohort was pro-inflammatory as a result of significant IL-6 and TNF alpha expression. The anti-inflammatory markers (i.e. Th2 cytokines, namely IL4 and IL10) were poorly expressed by the whole cohort, with IL 4 seen almost exclusively in the IPH group, thus counter-balancing the predominantly pro-inflammatory milieu only in this group. PPH group had a pro-inflammatory milieu comparable to the HN control. IL 6 was the predominant cytokine in all groups, and as expected, it increased with advancing gestation in all the groups. This highly pro-inflammatory milieu was unexpected and needs further review

Conclusion

Long use of HAART suppresses the anti-inflammatory markers previously reported to be conducive for the wellbeing of pregnancy. This effect needs further review as it was similarly observed in our HIV uninfected controls.

中文翻译：

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HAART持续时间对妊娠期细胞因子谱的影响。

客观的

确定在怀孕期间接受高活性抗逆转录病毒疗法 (HAART) 治疗的 HIV 感染妇女的细胞因子谱。

方法

感染 HIV 的妇女在其产前期间在南非德班的一家大型三级医院入组，并分为在怀孕前开始 HAART 的妇女（怀孕前 HAART 或 PPH 组）和在怀孕期间开始 HAART 的妇女（怀孕期间 HAART 或IPH 组）。这些与 HIV 阴性女性（HN 组）进行了比较，这些女性在登记时与孕龄相匹配。使用 Bio-Plex Pro™ Human Cytokine Treg Panels 获得血清并测定 Th1 和 Th2 细胞因子的表达。

结果

由于显着的 IL-6 和 TNF α 表达，队列的整体细胞因子谱是促炎的。抗炎标志物（即 Th2 细胞因子，即 IL4 和 IL10）在整个队列中表达较差，IL 4 几乎只在 IPH 组中出现，因此仅在该组中抵消了主要的促炎环境。PPH 组具有与 HN 对照相当的促炎环境。IL 6 是所有组中的主要细胞因子，正如预期的那样，它在所有组中随着妊娠的推进而增加。这种高度促炎的环境是出乎意料的，需要进一步审查

结论

长期使用 HAART 会抑制先前报道的有利于怀孕的抗炎标志物。这种影响需要进一步审查，因为在我们的 HIV 未感染对照中也观察到了类似的情况。