Cd4⁺lymphocytes in perinatal human immunodeficiency virus (hiv) infection: Evidence for pregnancy-induced immune depressionin uninfected and hiv-infeeted women

Immune function changes during pregnancy and human immunodeficiency virus (HIV) infection. T helper function and phenotypes in HIV-infected and -uninfected pregnant and postpartum women and nonpregnant uninfected control women were studied. T helper function was assessed by interleukin- 2 (IL-2) production in vitro and three-color flow cytometry. All uninfected nonpregnant subjects, 74% of uninfected pregnant subjects, and only 54% of HIV-infected pregnant subjects responded to all stimuli. All uninfected subjects 2-6 months postpartum had normal function versus 27% of infected subjects (trend P <.001). Uninfected pregnant subjects had reduced levels of CD4⁺CD45RA^–RO⁺(memory) and elevated levels of CD4⁺CD45RA⁺RO^–(naive) lymphocytes. Infected pregnant subjects had elevated levels of memory, reduced levels of naive, and increased levels of CD4⁺HLA-DR⁺CD38⁺(activated) lymphocytes. Increased CD4⁺DR⁺CD38⁺cells correlated best with poor IL-2 function, HIV infection, and being postpartum (R²=.79). Thus, T helper function and phenotypes are altered in pregnancy and return to baseline postpartum in uninfected but not HIV-infected women.