Early spontaneous abortions and fetal thymic abnormalities in maternal-to-fetal HIV infection

The thymus is thought to play a major role in the immunopathogenesis of human immunodeficiency virus (HIV) infection, particularly in maternal‐to‐fetal HIV transmission. Characteristic lesions of the HIV‐infected thymus include a prominent CD4+ CD8+ T lymphocyte depletion at the corticomedullary jun...

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Bibliographic Details
Published in:	Acta Paediatrica Vol. 86; no. S421; pp. 60 - 64
Main Authors:	Shearer, WT, Langston, C., Lewis, DE, Pham, EL, Hammill, HH, Kozinetz, CA, Kline, MW, Hanson, IC, Popek, EJ
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-06-1997
Subjects:	Abortion Abortion, Spontaneous - etiology Abortion, Spontaneous - immunology CD4 antigen CD4+ CD8+ T lymphocyte depletion CD8 antigen corticomedullary junction Cytokines Disease transmission Female Fetal Diseases - immunology Fetal Diseases - pathology Fetuses Gestational Age Glands HIV Infections - immunology HIV Infections - pathology HIV Infections - transmission Human immunodeficiency virus Humans immune rejection of the fetus immune selection Immunopathogenesis Infection Infectious Disease Transmission, Vertical Lymphocytes T Pregnancy Pregnancy Complications, Infectious - immunology Pregnancy Complications, Infectious - pathology threefold excess early spontaneous abortions Thymus Thymus Gland - abnormalities Thymus Gland - immunology Thymus Gland - pathology
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Summary:	The thymus is thought to play a major role in the immunopathogenesis of human immunodeficiency virus (HIV) infection, particularly in maternal‐to‐fetal HIV transmission. Characteristic lesions of the HIV‐infected thymus include a prominent CD4+ CD8+ T lymphocyte depletion at the corticomedullary junction, the region of the thymus where immune selection occurs. At least threefold excess early spontaneous abortions were noted in a cohort of 124 HIV‐infected pregnant women. In these 13 abortuses a very high rate (54%) of HIV vertical transmission was documented, with the thymus gland particularly affected. It is possible that the thymic insult in HIV‐infected fetuses contributes to immune rejection of the fetus, possibly by an imbalance of maternal and fetal T1‐ and T2‐type cytokines, known to be important in HIV disease progression. We propose, therefore, that the early spontaneous abortions occurring in HIV‐infected pregnant women are due, at least in part, to abnormal immune forces created by HIV infection of the thymus.
Bibliography:	istex:A3BD6AC59F829F1E801237740638F3FB64F591E9 ArticleID:APA18322 ark:/67375/WNG-CKNZ9GXZ-B ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0803-5253 0803-5326 1651-2227
DOI:	10.1111/j.1651-2227.1997.tb18322.x