Persistent Immune activation in HIV-Infected Pregnant Women Initiating cART Post Conception.

This study reports the impact of HIV and antiretroviral therapy (cART) on immune activation during pregnancy in a Zambian cohort of HIV exposed but uninfected children followed from birth. Activated CD8+ T-cells (CD38+ and HLA-DR+) were compared among HIV- (N=95), HIV+/cART experienced (N=111) and HIV+/cART naive (N=21) pregnant women. Immune activation was highest among HIV+/cART naive women but decreased during pregnancy. HIV+ women who started cART during pregnancy reduced immune activation but not to levels similar to HIV- women. The effects of elevated maternal immune activation in pregnancy on subsequent infant health and immunity remain to be determined.