血液疾患と輸血ジャーナル

概要

The Preterm Effect of Antiretroviral Drugs on Total Lymphocyte Cells and CD4 Cells in HIV-Infected Pregnant Women

Okeke Chukwubike Udoka, Ukibe Solomon Nwabueze, Holy Brown and Ezeiruaku Ferdinand

Background: HIV infected pregnant women are placed on antiretroviral drugs for treatment and to avoid maternal to child transmission of HIV. This study was carried out to investigate the effects of the antiretroviral drugs (ARD) on CD4 and Total Lymphocyte cell count (TLC) among these women.

Method: A total of 120 women participated in this study at Bori General Hospital Nigeria. Sixty (60) of them were seropositive to HIV while 60 were seronegative. Blood sample was collected from both groups of women at 2nd and 3rd trimester. The seropositve group was placed on ARD (Nevirapine, Zidovudine) after initial collection of sample at 2 nd trimester. CD4 count and TLC were estimated in these samples using Cyflow machine and manual method respectively.

Result: CD4 count and TLC were significantly (p < 0.05) reduced in HIV infected pregnant women (CD4 count 425.10 ± 34.0 cells/uL, TLC 1.97 ± 0.10 × 109 /L) in 2nd trimester than in non- infected group (CD4 count 835.02 ± 36.50 cells/uL, TLC count 2.93 ± 0.15 × 109 /L). The CD4 count significantly rose from 425.10 ± 34.0 cells/uL in 2nd trimester to 647.03 ± 35.77cells/uL in 3rd trimester, and TLC significantly rose (p < 0.05) from 1.97 ± 0.10 × 109 /L in 2 nd trimester to 2.26 ± 0.10 × 109 /L in 3rd trimester in HIV-infected group. The increase in CD4 cell count (647.03 ± 35.77 cells/uL) in sero-positive group at 3rd trimester was significantly lower (p < 0.05) than that of sero- negative group (948.58 ± 38.86 cells/uL). TLC levels in 3rd trimester of both sero-positive group and sero-negative group showed no statistical significant (p > 0.05) difference.

Conclusion: Reduction of CD4 cell count and TLC at 2nd trimester in HIV- infected pregnant women showed that HIV infection depleted these immunologic markers in pregnancy. The administration of ARD from second trimester boosted the CD4 cell count and TLC among these infected pregnant women before delivery. Progressive increase in TLC alongside CD4 cell count among the women on ARD suggests that TLC could be used as a surrogate to monitor progress of treatment among HIV-infected pregnant women in resource limited settings.