Abstract:
INTRODUCTION
Preeclampsia and HIV/AIDS are inflammatory conditions that contribute significantly to
adverse maternal and foetal outcomes. The immune reconstitution effects of HAART on
inflammatory mediators has not been adequately studied in pregnancy and may impact on
the inflammatory cytokine network in women with co-morbid preeclampsia. Our study evaluated
changes in pro-inflammatory cytokines IL-2, TNF-α, IFN-γ and IL-6 in HIV infected preeclamptic
women on HAART.
METHODS
A prospective experimental study was conducted at Prince Mshiyeni Memorial Hospital
between July 2013 and September 2014. One hundred and ninety three pregnant women
were recruited into 4 groups: uninfected normotensive (50; 26%), infected normotensive
(45; 23%), uninfected preeclamptic (53; 28%) and infected preeclamptic women (45; 23%).
Serum levels of cytokines TNF-α, IFN- γ, IL-2 and IL-6 were determined using commercially
available kits and a Cytometric Bead Array (CBA). Comparative data was recorded and analysed
descriptively.
RESULTS
In the control groups (normotensive), significantly lower values were found in IL-2
(p = 0.010), TNF-α (p = 0.045), and IL-6 (p = 0.005); and a non-significant decrease was
observed in IFN-γ (p = 0.345) in HIV infected women on HAART compared to uninfected controls. In the experimental group (preeclamptic) women, significantly reduced levels were
observed in IL-2 and TNF-α (p = 0.001; p = 0.000) and non-significant decreases were
observed in IFN-γ and IL-6 (p = 0.023; p = 0.086) in HIV infected women on HAART compared with uninfected preeclamptic women. Non-significant differences were observed
between uninfected preeclamptic and normotensive women.
CONCLUSION
In uncomplicated/normotensive pregnancies, HIV/HAART is associated with significant
decreases in IL-2, TNF-α and IL-6, and in preeclamptic women significant decreases in IL-2
and TNF-α were observed. These findings suggest that HIV/HAART impacts on pro-inflammatory
cytokines in women with co-morbid preeclampsia. This provides a platform for further
research on immune reconstitution effects of HAART during pregnancy, and the
development of potential immune modulation therapies for the management of
preeclampsia.
