Longitudinal study of CD4⁺ cell counts in HIV-negative pregnant patients

Abstract

Objective. To evaluate the absolute CD4⁺, CD8⁺, and lymphocyte cell counts and percentages from the first trimester through 6–12 weeks post-delivery in normal human immunodeficiency virus (HIV)-negative pregnant patients.

Methods. A longitudinal laboratory analysis was performed during pregnancy that involved 51 HIV-negative subjects with blood analysis obtained in all trimesters, at delivery, and 6–12 weeks post-delivery. Twenty-five HIV-negative non-pregnant controls were also evaluated. Blood was analysed for absolute CD4⁺, CD8⁺, and lymphocyte cell counts and percentages. Means, standard deviations, trends, and differences were examined.

Results. The mean white blood cell (WBC) count is elevated above the non-pregnant state and this parameter increases through the pregnancy up to and including parturition. The mean absolute lymphocyte cell count, lymphocyte percentage, and absolute CD4⁺ cell count are significantly lower during pregnancy and the progression through pregnancy appears U-shaped. The mean absolute CD8⁺ cell count is not significantly different. The CD4⁺ and CD8⁺ percentages are higher during pregnancy and this elevation persists into the 6–12 week post-delivery time period. A 3-digit drop in CD4⁺ percentage is common during pregnancy between blood draws; whereas, a 30% decrease or more in absolute CD4⁺ cell count is rare.

Conclusions. By longitudinal analysis, pregnancy appears to significantly elevate the mean values of the WBC count, CD4⁺ percentage, and CD8⁺ percentage, but significantly decreases the absolute lymphocyte count, lymphocyte percentage, and absolute CD4⁺ cell count when compared to non-pregnant controls. The mean absolute CD8⁺ cell count appears to be unaffected.

Keywords:

• CD4⁺ cell counts in pregnancy
• CD4⁺ cell counts in pregnancy
• human immunodeficiency virus in pregnancy
• lymphocyte subsets in pregnancy

Acknowledgement

Financial support for the study was given by The Memorial Medical Center Foundation.