Comparative study of Serum Immunoglobulin levels in Healthy Pregnant and Pregnant Subjects with HIV and Malaria Infection in Port Harcourt, Nigeria

摘要

The present study aims to determine IgA, IgG and IgM concentrations in healthy pregnant subjects, subjects with malaria and HIV infection during pregnancy as compared to healthy HIV sero-negative non-pregnant subjects in Port Harcourt, Nigeria. The study is purposed to enable better understanding of the pattern of changes of immunoglobulin concentration in malaria and HIV infection and assist in the antenatal management of these subjects in our environment. In all, 200 female subjects in Port-Harcourt, southeastern Nigeria were incorporated into the study. These comprised four groups of 50 female subjects in each group: healthy HIV non-pregnant subjects (group A); healthy HIV pregnant subjects (group B); subjects with malaria infection during pregnancy (group C) and; HIV sero-positive pregnant subjects (group D). All pregnant women were further divided to the appropriate trimester depending on the duration of their pregnancy. Venous blood samples were obtained and levels of immunoglobulins A, G and M determined with the turbidimetric immunoassay method using an automated chemical analyzer. Statically significant differences were observed in the values of the various immunoglobuliniso types studied between healthy HIV non-pregnant (group A) subjects and healthy HIV pregnant (group B) subjects. Noteworthy is the observation that the mean values of both IgG and IgM were significantly higher while the values of IgA were significantly lower amongst the non-pregnant subjects in group A, compared to all the other pregnant subject groups: B, C and D (p<0.05). Furthermore, the healthy pregnant subjects (B) had significantly higher values of both IgG and IgM compared to group C subjects, but significantly lower values compared to group D subjects (p<0.05). Mean IgA values were found to be consistently higher in both pregnant malaria (C) and HIV (D) groups as compared to both groups A and group B subjects. During the course of gestation, both groups C and D subjects were observed to have significantly higher values of IgA compared to group B women (p<0.05); whereas group C subjects had markedly lower values of both IgG and IgM compared to group B subjects (p<0.05). Group D subjects were also observed to have significantly higher values of both IgG and IgM relative to group B subjects (p<0.05). These differences were found to exist despite the duration of gestation. This study reports that IgG and IgM levels were significantly lower and IgA values significantly increased in the pregnant subjects compared to the non-pregnant subjects. Furthermore, in subjects with malaria in pregnancy IgG and IgM levels were consistently and significantly low and IgA levels being the lowest amongst the healthy pregnant subjects. Our study describes for the first time the pattern of these changes in immunoglobulin values amongst pregnant subjects of southeastern Nigeria and confirms previous suggestions of an apparent modulation of the immune system by the effects of both pregnancy and malaria infection during pregnancy. We recommend the continual need for adequate checks and enhanced care of these subjects by antenatal care providers in southeastern Nigeria.