ABSTRACT
BACKGROUND: The conjoint effect of HIV infection and pregnancy on the immune system of women submitted to the prophylactic antiretroviral therapy presently recommended is still poorly understood. METHODS: We evaluated 44 HIV-infected women (HIV) and 45 HIV-negative women (CT) at parturition and we compared them to 20 healthy nonpregnant women (NP). Immunophenotyping of lymphocytes was done by four-color flow cytometry. RESULTS: All HIV-infected women received HAART during pregnancy and 56.8% had viral load <50 copies/mL at delivery. CD4+T cells/mm(3) were lower in HIV (447) than CT (593) and NP (738) (P < 0.05). CD8+T cells/mm(3) were higher in HIV (799) than CT (384) and NP (395) (P < 0.05). NK cells/mm(3) were lower in HIV (146) than in CT (253) and NP (198) (P < 0.05). CD38 expression on CD4+T and on CD8+T cells was higher in HIV (CD4:12.1; CD8:14.9) than in CT(CD4:9.2; CD8:10.2) and NP(CD4:8.6; CD8:6.0) (P < 0.05). However, CD56 expression on CD8+T cells (a marker of cytolytic effector function) was lower in HIV(7%) than in CT(12%) and NP(9%) (P < 0.05). CONCLUSIONS: Even with low levels of viremia, HIV-infected women at delivery showed a different immunologic profile from both healthy non-HIV-infected women in the puerperium and nonpregnant women, with lower CD4+T and higher CD8+T cells, high levels of CD38 expression, but low CD56 expression on CD8+T cells and low NK cell numbers.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , HIV Infections/immunology , HIV-1/immunology , Pregnancy Complications, Infectious , ADP-ribosyl Cyclase 1/immunology , Adolescent , Adult , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Female , HIV Infections/blood , HIV Seropositivity , Humans , Immunophenotyping , Interleukin-7/blood , Interleukin-7/immunology , Killer Cells, Natural/immunology , Lymphocyte Activation , Lymphocyte Count , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/immunology , Pregnancy Complications, Infectious/virology , T-Lymphocyte Subsets/immunology , Viral Load , ViremiaSubject(s)
Female , Pregnancy , Humans , Cesarean Section , Cesarean Section/statistics & numerical data , Cesarean SectionSubject(s)
Humans , Female , Pregnancy , Lipids/metabolism , Fetal Development , Hyperlipidemias/etiologyABSTRACT
Os autores referem que a chamada "gravidez de baixo risco" näo pode ser subestimada, uma vez que as perdas perinatais que ela origina säo igualmente relevantes. Criticam as tabelas que relatam e quantificam os fatores de riscos na gravidez. Julgam todo feto digno de ter avaliado o próprio bem-estar fetal possui um valor de prognose que näo pode ser atribuído a caracterizaçäo da gravidez em critérios de risco
Subject(s)
Pregnancy , Humans , Female , Maternal and Child Health , Prenatal CareABSTRACT
Os autores referem que a chamada "gravidez de baixo risco" näo pode ser subestimada, uma vez que as perdas perinatais que ela origina säo igualmente relevantes. Criticam as tabelas que relatam e quantificam os fatores de risco na gravidez. Julgam todo feto digno de ter avaliado o próprio bem-estar. Consideram que a propedêutica individualizada do bem-estar fetar possui um valor de prognose que näo pode ser atribuido a caracterizaçäo da gravidez em critérios de risco
Subject(s)
Pregnancy , Humans , Female , Perinatal Mortality/epidemiology , Pregnancy Complications , Risk , Risk FactorsABSTRACT
Foram analisadas 63 pacientes portadoras de insuficiência istmocervical tratadas por circlagem segundo técnica proposta por McDonald. Observou-se que, apesar da circlagem, o índice de prematuridade foi elevado (30,2%). Houve grande número (27%) de recém-nascidos com peso < 2.500g e a neomortalidade precoce foi elevada. A circlagem à McDonald melhorou o prognóstico do concepto no tocante à sobrevida fetal, embora muitas vezes näo tenha evitado a interrupçäo prematura da gravidez
Subject(s)
Pregnancy , Humans , Female , Uterine Cervical Incompetence/surgery , Infant, Newborn , Birth Weight , Infant, Premature , Infant Mortality , Gestational Age , Methods , Prognosis , Infant, Small for Gestational AgeABSTRACT
É apresentada uma revisäo sobre os tumores das células da granulosa e descrito um caso de ocorrência em associaçäo a gravidez
