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

Acta Paediatr Suppl. 1997 Jun;421:60-4. doi: 10.1111/j.1651-2227.1997.tb18322.x.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Abortion, Spontaneous / etiology
  • Abortion, Spontaneous / immunology*
  • Female
  • Fetal Diseases / immunology*
  • Fetal Diseases / pathology
  • Gestational Age
  • HIV Infections / immunology*
  • HIV Infections / pathology
  • HIV Infections / transmission*
  • Humans
  • Infectious Disease Transmission, Vertical*
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology*
  • Pregnancy Complications, Infectious / pathology
  • Thymus Gland / abnormalities*
  • Thymus Gland / immunology*
  • Thymus Gland / pathology