Two of the newborns had HIV, and on

Two of the newborns had HIV, and one of these died (the vertical transmission rate in this study was 3.51%).Morphometric analysis showed that there were significant differences between the areas and perimeters of the villi in placentas from HIV-seropositive women and the corresponding areas and perimeters for HIV-seronegative women, the mean values for the latter group being higher (Table 2). These results suggest that the villi in placentas from the HIV-seronegative group may be larger than those from the HIV-seropositive group. Statistical analysis excluding cases in which pregnancies were not carried to term (gestational age of 25/36 weeks) failed to reveal any changes in the statistically significant data.No statistically significant differences were found between the two groups of women in terms of the results for the immunohistochemical tests to detect p24 and antigens from Toxoplasma gondii, cytomegalovirus, herpes simplex I and II and Treponema pallidum (Table 3). Viral load measurements in the newborns whose placentas were positive for p24 (two placentas) failed to confirm maternal-fetal transmission. In contrast, the placentas of the two cases with fetal transmission were not positive for the p24 antigen.ICAM-I was expressed both in vessels of the villous stroma and in Hofbauer cells. Expression of this molecule was observed in a larger percentage of cases in the HIV-seropositive group (57%), compared with only 21% of the cases in the control group. VCAM-1 was expressed in a small number of cases in both groups (3.6% in the seropositive group and 5.2% in the seronegative group) and was always observed in the vessels of the villous stroma (table 3).CD4+ and CD8+ cell counts showed that there was a greater prevalence of CD8+ T cells in the HIV-seropositive women. No statistically significant difference in the number of CD4+ cells was observed in the placentas analyzed. CD4+ T cells were inconspicuous in all the cases, and the cells with the greatest positivity for CD4 were Hofbauer cells. The median CD8+ T cell count in HIV-seropositive pregnant women was 1.87 per HPF, and the corresponding figure in the control group was 1.46. This difference was statistically significant (p = 0.03) (Table 3).Analysis of the viral loads revealed that these were measured between three and six times for most of the patients and that 54.1% had an initial viral load, during the first trimester of gestation, of less than 1000 copies. Taking the average of the three main viral loads measured during the pregnancies, we found that 72% of the women had a mean value of more than 2000 copies (Table 4). Comparison of the area and perimeter of the villi, ICAM-1 expression and CD8+ T-cell concentration with mean patient viral load failed to reveal any statistically significant correlations.The use of appropriate antiretroviral therapy in the HIV-seropositive women and its relationship with markers of the disease were also analyzed. Antiretroviral therapy administered for at least one month no later than one month before the birth was considered appropriate therapy (therapy +), while antiretroviral therapy administered for less than one month prior to the birth or failure to administer therapy was considered inappropriate or absent therapy (therapy -). No statistically significant correlation was observed between CD8+ T-cell count or the area and perimeter of the villi and the use of antiretroviral drugs. However, a correlation was observed with ICAM-1 expression, which was higher in the group that had received therapy (p = 0.03), as well as with viral load, which was lower in the same group (p = 0.01) (Table 5).