Influence of systemic inflammation predictors on the premature labor of hiv-infected women living in Subarctic region

Abstract

The goal is to conduct a comparative analysis of the characteristics of blood counts of pregnant women with HIV living in the subarctic climatic zone of the Khanty-Mansiysk District, as predictors of a systemic inflammatory reaction on the background of infection and pregnancy complicated by preterm delivery.Material and methods. A retrospective analysis of 78 stories of pregnant women with HIV (main group II) was carried out, in 2016–2018. observed in one antenatal clinic in the city of Surgut. Control group (I) comprised 20 histories of pregnant women without HIV. Clinical-anamnestic and blood parameters were compared, including indicators of T-helpers, T-suppressors and viral load, leukocyte intoxication indices, hemoglobin, erythrocytes and platelets by trimesters of pregnancy. The material was processed using the Statistica-10 software system. The critical level of statistical significance was taken at p<0,05.Results. A comparative analysis of blood counts of pregnant women living in the subarctic region showed a relationship between the preterm labor of patients with HIV with a progressive decrease in the T-cell level of immunity, an increase in the level of lymphocytes and leukocyte blood indices, a decrease of hemoglobin, erythrocytes, platelets, against the background of persisting viral load for the remainder of pregnancy. A decrease of T-lymphocyte counts indicates the development of a systemic inflammatory response on the background of HIV infection, depletion of the immune defense organs and the progression of the disease, while a low level of CD4 lymphocytes stimulates the activation of granulocytes in the blood and indicates further depletion of T-lymphocytes. Activation of a systemic inflammatory response that promotes the release of inflammatory mediators and prostaglandins and, with a high probability, underlies the mechanisms of rejection of the fetus and placenta and the spontaneous preterm labor. The comorbid background of pregnant women with HIV and preterm labor is associated with low adherence to HAART therapy and high detectable viral load throughout gestation.