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Higher inflammatory markers linked to preterm delivery in women with HIV
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Higher levels of certain inflammatory markers, including soluble CD14 and lipopolysaccharide binding protein, were found in HIV-infected pregnant women and were associated with preterm delivery, according to recently published data.
In a prospective cohort study conducted at the Hospital Clínic in Barcelona, researchers assessed the role of lipopolysaccharide modulators as indicators of microbial translocation during pregnancy in women with HIV.
Blood samples from 36 pregnant women with HIV and 36 pregnant women without HIV were collected and matched for age and parity during the first and third trimesters and at delivery. The researchers determined the women’s soluble CD14 (sCD14), human lipopolysaccharide binding protein (LBP), IgMEndoCAb and IL-6 and tested fetal blood cord sCD14, LBP and IL-6.
HIV-positive women had significantly greater sCD14 and LBP levels in the first trimester and significantly higher sCD14 levels in the third trimester. Women with HIV who had preterm birth before 37 weeks gestation and spontaneous preterm births, defined as preterm labor or premature membrane rupture, had higher sCD14 levels during their entire pregnancies (P < .001 in first trimester; P < .001 in third trimester; and P = .023 at delivery) and increased LBP levels during the first (P = .024) and third (P = .049) trimesters, compared with HIV-positive women who delivered at term and HIV-negative women.
Multivariate analysis adjusted for black ethnicity, low education level, smoking during pregnancy, drug use and previous preterm birth, revealed an independent association between sCD14 levels in the first trimester and preterm delivery among HIV-positive women (P = .022).
“First-trimester sCD14 can be considered a good predictor for preterm delivery among HIV-infected women as each 100 ng/mL increase was related to a 19.5% increase of risk of preterm delivery,” the researchers wrote.
No differences were observed in cord blood samples for fetal LBP, sCD14 or IL-6 levels. The researchers also found no association between preterm birth and ART or protease inhibitor use.
“If the results of this study are confirmed, therapeutic strategies such as prebiotic supplementation to regulate microbial translation or N-acetilcysteine to control chronic inflammation could be assessed to prevent prematurity among HIV-infected pregnant women.” – by Tina DiMarcantonio
Disclosure: The researchers report no relevant financial disclosures.
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