Immunology of HIV and pregnancy: The effects of each on the other

D. V. Landers, B. M. De Tejada, B. A. Coyne

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Infection with HIV may significantly affect the human immune response. Depletion of CD4 T cells directly or indirectly results in global immune dysfunction, including both cellular and humoral components of the immune system. Ongoing viral replication leads to progressive immune destruction despite apparent clinical latency. The end result, if left untreated, is CD4 T-cell depletion, severe immune compromise, opportunistic infection, and eventual death. Pregnancy has been purported to induce an altered immune state to protect the fetus from immune ejection that may leave the mother with impaired immunity. This theoretical risk has been overemphasized, and, in fact, only limited data suggest that certain infections may have worse presentations and outcomes during pregnancy. The mother maintains immunocompetence throughout gestation and is not overwhelmed with opportunistic infection. Women infected with HIV may experience some decline in CD4 T-cell percentages and possibly in function. It is not clear whether any of the effects will significantly affect long-term outcome. Infection with HIV may predispose pregnant women to a variety of adverse pregnancy outcomes, including preterm labor, prematurity, low-birth-weight infants, postpartum endometritis, and other infectious morbidity. Larger controlled studies are necessary to determine the frequency of these adverse outcomes and whether they will predominantly affect the severely immunocompromised HIV-infected pregnant women.

Original languageEnglish (US)
Pages (from-to)821-831
Number of pages11
JournalObstetrics and Gynecology Clinics of North America
Volume24
Issue number4
DOIs
StatePublished - Jan 1 1997

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