Maternal CD4 + microchimerism in HIV-exposed newborns after spontaneous vaginal delivery or caesarean section

Abstract Background Maternal CD4 + cell microchimerism may be greater after caesarean section compared to spontaneous vaginal delivery and could cause mother-to-child transmission (MTCT) in HIV-exposed newborns. Aims To evaluate maternal CD4 + cell microchimerism in HIV-exposed newborns after sponta...

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Bibliographic Details
Published in:	Early human development Vol. 98; pp. 49 - 55
Main Authors:	Buxmann, H, Reitter, A, Bapistella, S, Stürmer, M, Königs, C, Ackermann, H, Louwen, F, Bader, P, Schlößer, R.L, Willasch, A.M
Format:	Journal Article
Language:	English
Published:	Ireland Elsevier Ireland Ltd 01-07-2016
Subjects:	Adult Advanced Basic Science CD4 + cell microchimerism CD4-Positive T-Lymphocytes - virology Cesarean Section - adverse effects DNA, Viral - genetics Female HIV HIV Infections - blood HIV Infections - transmission Humans Infant, Newborn Infectious Disease Transmission, Vertical Male Mode of delivery Mother-to-child transmission Neonatal and Perinatal Medicine Newborn Pregnancy Pregnancy Complications, Infectious - blood ribonucleic acid RNA cluster of differentiation combination of antiretroviral therapy ITT intention-to-treat caesarean section Ct min magnetic cell sorting deoxyribonucleic acid threshold cycle Mode of delivery polymerase chain reaction mother-to-child transmission CD max MACS a-pH EDTA cART CD4 + cell microchimerism CS Newborn HIV DNA human immunodeficiency virus maximum MTCT arterial cord blood pH minimum PCR ethylenediamine tetraacetic acid CD4+ cell microchimerism Mother-to-child transmission
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Summary:	Abstract Background Maternal CD4 + cell microchimerism may be greater after caesarean section compared to spontaneous vaginal delivery and could cause mother-to-child transmission (MTCT) in HIV-exposed newborns. Aims To evaluate maternal CD4 + cell microchimerism in HIV-exposed newborns after spontaneous vaginal delivery or caesarean section. Study design and subjects In this prospective single-centre study, neonates whose mothers were infected with HIV and had normal MTCT risk according to the German Austrian Guidelines were considered for study enrolment. Maternal CD4 + cell microchimerism in the newborns' umbilical cord blood was measured and compared by mode of delivery. Results Thirty-seven HIV-infected mothers and their 39 newborns were included in the study. None of the 17 (0.0%) newborns delivered vaginally had quantifiable maternal CD4 + cells (95% confidence interval (CI): 0.00–0.00) in their circulation at birth compared with four of 16 (25.0%) newborns delivered via planned caesarean section, who showed 0.01–0.66% maternal cells (95% CI: − 0.06–0.16; P = 0.02) in their circulation. The intention to treat analysis, which included six additional newborns delivered by unplanned caesarean section, showed quantifiable maternal CD4 + cells in one (0.05%; 95% CI: − 0.02–0.04) of 23 (4.3%) newborn at birth compared to four of 16 (25.0%) born via planned caesarean section (95% CI: − 0.06–0.16; P = 0.04). There was no MTCT in any of the newborns. Conclusion In this small cohort, spontaneous vaginal delivery in HIV-infected women with normal MTCT risk was associated with lower maternal CD4 + cell transfer to newborns compared to planned caesarean section.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0378-3782 1872-6232
DOI:	10.1016/j.earlhumdev.2016.06.004