Antiretroviral therapy-associated modulation of Th1 and Th2 immune responses in HIV-infected pregnant women

Fiore, Simona; Newell, Marie‐Louise; Trabattoni, Daria; Thorne, Claire; Gray, Linsay; Savasi, Valeria; Tibaldi, Cecilia; Ferrazzi, E.; Clerici, Mario

doi:10.1016/j.jri.2005.12.001

Cited by 88 publications

(66 citation statements)

References 16 publications

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“…[27][28][29][30][31][32][33] ART may potentiate this risk through a similar mechanism. 27,28 Limited research exists regarding the interaction between antiretroviral and antimalarial drugs, but the protease inhibitor component of ART may have antimalarial properties by inhibiting parasite growth. 14,34,35 The antimalarial drugs chloroquine and hydroxychloroquine have also been shown to have antiretroviral activity in vitro and in vivo.…”

Section: Discussionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

et al. 2016

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Abstract. In Lusaka, Zambia, where malaria prevalence is low, national guidelines continue to recommend that all pregnant women receive sulfadoxine-pyrimethamine (SP) for malaria prophylaxis monthly at every scheduled antenatal care visit after 16 weeks of gestation. Human immunodeficiency virus (HIV)-positive women should receive co-trimoxazole prophylaxis for HIV and not SP, but many still receive SP. We sought to determine whether increased dosage of SP is still associated with a reduced risk of low birth weight (LBW) in an area where malaria transmission is low. Our secondary objective was to determine whether any association between SP and LBW is modified by receipt of antiretroviral therapy (ART). We analyzed data routinely collected from a cohort of HIV-positive pregnant women with singleton births in Lusaka, Zambia, between February 2006 and December 2012. We used a logPoisson model to estimate the risk of LBW by dosage of SP and to determine whether the association between SP and LBW varied by receipt of ART. Risk of LBW declined as the number of doses increased and appeared lowest among women who received three doses (adjusted risk ratio [ARR] = 0.78; 95% confidence interval [CI] = 0.64-0.95). In addition, women receiving combination ART had a higher risk of delivering an LBW infant compared with women receiving no treatment or prophylaxis (ARR = 1.18; 95% CI = 1.09-1.28), but this risk was attenuated among women who were receiving SP (risk ratio = 1.09; 95% CI = 0.99-1.21). SP was associated with a reduced risk of LBW in HIVpositive women, including those receiving ART, in a low malaria prevalence region.

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Section: Discussionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

et al. 2016

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“…Fiore et al showed that the physiological Th1 to Th2 shift that occurs during pregnancy was reversed in HIV-1-infected mothers who had conceived while receiving HAART [7] and may account for PTD seen with HAART. It is biologically plausible that such an effect may be more dramatic if effective antiretroviral therapy is initiated during the pregnancy.…”

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confidence: 99%

Increased Rates of Preterm Delivery Are Associated with the Initiation of Highly Active Antiretrovial Therapy during Pregnancy: A Single‐Center Cohort Study

Martin

Taylor

2007

J INFECT DIS

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It remains controversial whether in human immunodeficiency virus (HIV)-positive pregnant women an increased rate of preterm delivery is associated with highly active antiretroviral therapy (HAART). Since 1995 the management and outcome of all HIV-infected pregnant women delivering at St. Mary's Hospital London have been prospectively documented. The prevalence of preterm delivery and the correlation between gestational age and type of antiretroviral therapy were sought: preterm delivery occurred in 14.2% of the 211 deliveries. Initiation of HAART during pregnancy was associated with an increased risk of preterm delivery. This was independent of maternal health and class of antiretroviral therapy.

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“…HIV-infected pregnant women using HAART present a shift towards a Th 1 cytokine production while, in a healthy pregnancy, a Th 2 response is predominantly observed [62,63]. Also a Th 1 immune response is observed in PE [64]. It is possible that HIV-infected pregnant women on HAART, especially those with long exposure to therapy, would have a blunted shift of Th 2 cytokines increasing the predisposition to eclampsia [64].…”

Section: Discussionmentioning

confidence: 99%

“…Also a Th 1 immune response is observed in PE [64]. It is possible that HIV-infected pregnant women on HAART, especially those with long exposure to therapy, would have a blunted shift of Th 2 cytokines increasing the predisposition to eclampsia [64].…”

Section: Discussionmentioning

confidence: 99%

Possible Changes in Maternal Plasma Cortisol, AdrenocorticotropicHormones, Pregnancy Associated Plasma Protein-A and Alpha-fetoproteinin HIV Pregnant Women at NAUTH Nnewi, Nigeria

Ukibe¹,

Onyenekwe²,

Anojulu³

et al. 2015

J Bioanal Biomed

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Background: There is limited information on if HIV infection induces stress in pregnancy. HIV can possibly contribute to the alterations in some fetal viability hormones thereby lead to adverse pregnancy outcome. The present study aimed to assess the possible changes in maternal cortisol, Adrenocorticotropic (ACTH), Pregnancy associated plasma protein-A (PAPP-A) and alpha-fetoprotein (AFP) hormone concentrations in HIV-infected pregnant women and their pregnancy outcomes. Methods:A cross sectional study of 80 (Eighty) volunteer pregnant women aged (18-49) years recruited during routine antenatal clinics in Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria was conducted. The participants were divided into groups: 40 (forty) apparently healthy pregnant and 40 (forty) HIV-infected pregnant women. 5 ml of morning blood samples were collected from each subject in their 1 st and 2 nd trimesters for estimation of Cortisol, ACTH, AFP and PAPP-A using ELISA method. Results:The result showed that the mean systolic and diastolic blood pressures (mmHg) of HIV pregnant women were significantly higher than control (p<0.05 respectively). The mean value of cortisol (ng/ml) in HIV pregnant women was significantly higher when compared with control subjects (p<0.05). Cortisol showed inverse significant correlation with AFP in HIV-infected pregnant women. Maternal outcomes showed thatt HIV-infected pregnant women had significantly higher incidence of miscarriages and preeclampsia with higher incidence of perinatal outcomes such as low birth weight babies (LBW), preterm delivery, spontaneous abortion, still birth and low Apgar scores when compared with apparently normal pregnant women (P<0.05 respectively).Conclusion: the significantly higher cortisol level and BP in HIV pregnant women is indicative of oxidative stress due to perceived stress by HIV infection which might predispose the affected women to hypertension and preeclampsia. The highest adverse reactions observed in HIV pregnant women might be related to the damaged immune system by HIV infection however, the placental defect associated with increased placental permeability to AFP and the activity of the insulin-like growth factor (IGF) system is not related to the activity of stress thereby do not influence their birth outcomes.

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Antiretroviral therapy-associated modulation of Th1 and Th2 immune responses in HIV-infected pregnant women

Cited by 88 publications

References 16 publications

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Increased Rates of Preterm Delivery Are Associated with the Initiation of Highly Active Antiretrovial Therapy during Pregnancy: A Single‐Center Cohort Study

Possible Changes in Maternal Plasma Cortisol, AdrenocorticotropicHormones, Pregnancy Associated Plasma Protein-A and Alpha-fetoproteinin HIV Pregnant Women at NAUTH Nnewi, Nigeria

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