Unique profile of inflammation and immune activation in pregnant people with HIV in the United States
Background: Little is known about inflammation/immune activation during pregnancy in people with HIV (PWH) and growth in their children who are HIV-exposed and uninfected (CHEU). Methods: Using data from the Pediatric HIV/AIDS Cohort Study and an HIV-seronegative comparison group, we assessed associations of (1) HIV status, mode of HIV acquisition (perinatally vs nonperinatally acquired), and type of antiretroviral therapy (ART) with inflammation/immune activation in pregnancy; and (2) inflammation/immune activation in pregnancy with growth of CHEU at 12 months. Interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble(s) TNF-α receptor 1 and 2 (sTNFR1, sTNFR2), sCD14, and sCD163 were measured between 13 and 27 weeks’ gestation. Linear regression models were fit to estimate differences between groups for each log-transformed biomarker, adjusted for confounders. Results: Pregnant PWH (188 total, 39 perinatally acquired, 149 nonperinatally acquired) and 76 HIV-seronegative persons were included. PWH had higher IL-6, sTNFR1, sCD14, and sCD163 and lower sTNFR2 compared to HIV-seronegative persons in adjusted models. Among PWH, sCD163 was higher in those with perinatally versus nonperinatally acquired HIV and on PI-based versus INSTI-based ART. Higher maternal concentrations of IL-6, sTNFR2, and hs-CRP were associated with poorer growth at 12 months. Conclusions: Maternal HIV status is associated with a distinct profile of inflammation/immune activation during pregnancy, which may influence child growth.
Shiau, Stephanie, Denise L. Jacobson, Yanling Huo, Deborah Kacanek, Lynn M. Yee, David B. Williams, Lisa B. Haddad, Lena Serghides, Kathleen Powis, Rhoda S. Sperling, Paige L. Williams, Jennifer Jao, for the Pediatric HIV/AIDS Cohort Study. 2023. "Unique profile of inflammation and immune activation in pregnant people with HIV in the United States," Journal of Infectious Diseases 227(5): 720–730.