Inflammatory Markers Related to Microbial Translocation Among HIV-Infected Pregnant Women: A Risk Factor of Preterm Delivery

Abstract

This is the first study to assess inflammatory markers related to microbial translocation during pregnancy among HIV-infected women. Higher levels of sCD14 and LBP were observed in HIV-infected pregnant women and were associated with preterm delivery.

Soluble CD14 levels in plasma and breastmilk of Malawian HIV+ women: Lack of association with morbidity and mortality in their exposed infants

“…To our knowledge, this is the first time that this association is observed in low‐income countries, where the role of systemic immune activation markers may be confounded by other factors, such as malnutrition and maternal comorbidities, including opportunistic infections and/or vector transmissible diseases. An association between preterm delivery and increased levels of sCD14 during the first trimester of pregnancy has been described by Lopez and colleagues in HIV‐positive European women, suggesting a potential role for immune activation in the pathogenesis of preterm delivery. Although prematurity results in low birthweight, these two parameters should be considered conceptually distinct .…”

“…Recently, it has been shown that elevated sCD14 levels in the peripartum period are independent predictor of vertical transmission, but few studies have been performed to investigate whether sCD14 maternal concentrations during pregnancy and breastfeeding may impact on the clinical outcomes of HIV‐exposed children …”

“…Recently, an elevated level of sCD14 has been proposed as a risk factor for preterm delivery and for mother‐to‐child transmission (MTCT) in HIV‐positive women …”

Transfer of Maternal Antimicrobial Immunity to HIV-Exposed Uninfected Newborns

“…Maternal HIV infection is associated with an increased risk of preterm birth, a complication likely related to inflammation at the maternofetal interface (50, 51). Inflammation in the fetus may result in fetal inflammatory response syndrome, but the incidence of this syndrome in HIV-exposed fetuses has not been reported (52, 53).…”

“…No study has examined the transfer of cytokines through the placenta of HIV-infected women. A recent study suggested that maternal HIV infection is associated with increased serum levels of inflammatory markers related to microbial translocation [lipopolysaccharide (LPS) modulators soluble CD14 and LPS-binding protein] and that these markers were associated with preterm delivery (51); however, the cord blood levels of these pro-inflammatory mediators were not different among newborns of HIV-infected and -uninfected women, and the ratio of transfer across the placenta was not provided.…”