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The impact of the duration of HAART on cytokine profiles in pregnancy

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Abstract

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.

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Acknowledgements

We acknowledge the work of the research assistants, Grace Dlamini and Zama Khubone in the collection of data, statistician Partson Tinarwo in data analysis and Dr Charlette Tiloke for the manuscript preparations.

Author information

Authors and Affiliations

  1. Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    H. M. Sebitloane

  2. Optics and Imaging Centre, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    T. Naicker

  3. Women’s Health and HIV Research Unit, Discipline of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    J. Moodley

Authors
  1. H. M. Sebitloane
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  2. T. Naicker
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  3. J. Moodley
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Contributions

All authors have contributed to the concept, data collection (HMS), data interpretation (HMS), writing and approving the final manuscript (HMS, TN and JM).

Corresponding author

Correspondence to H. M. Sebitloane.

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The authors declare no conflicts of interest.

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Responsible Editor: John Di Battista.

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Sebitloane, H.M., Naicker, T. & Moodley, J. The impact of the duration of HAART on cytokine profiles in pregnancy. Inflamm. Res. 69, 1053–1058 (2020). https://doi.org/10.1007/s00011-020-01375-5

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  • DOI: https://doi.org/10.1007/s00011-020-01375-5

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