[Prospective study of the incidence of HIV infection in the 1st trimester of pregnancy]

The article deals with the results of an anonymous testing of HIV infections in Yugoslavia. The presence of anti-HIV-antibodies was examined in the blood of pregnant patients, randomly selected, in a Ward where about 3000 artificial abortions were carried out in the first trimester of pregnancy in a six-month period. On the basis of the obtained results one patient of 177 tested women was infected by HIV virus. At the same time, it can be presumed that among 3000 pregnancies there were many anti-HIV positive persons. It should be emphasized that the staff was not aware of HIV infection in one patient, and that in Yugoslav epidemiological conditions a HIV infected person could unexpectedly be detected without preliminary findings and data.

[HIV infection and human reproduction]

Problems connected with HIV infection, especially with its transmission, problems of HIV infection as an indicator of the termination of pregnancy, the role of pregnancy in the activation of latent HIV infection, and the possibility of the transmission of HIV infection by breast feeding are put forward and discussed. The authors present the results of their own studies of the presence of HIV antigen in the genital secretion, fetal tissue, and amniotic fluid in 4 anti-HIV positive pregnant women, in whom pregnancy was interrupted because of HIV infection. HIV antigen was positive in the cervical secretion and fetal tissue of one of the four pregnant women, whose diagnosis was ab. imminens. The presence of HIV virus, probably also of HIV antigen, in the cervical secretion appears significant for the transmission of infection from mother to child and for the occurrence of spontaneous abortion. When it is not possible to apply the method of HIV virus isolation, the determination of HIV antigen could have a prognostic importance of the effect of HIV on the course and outcome of pregnancy.

[HIV infection and immunity disorders in patients with hemophilia]

The clinical, serological and immunological status of 23 haemophilia patients (21 with haemophilia 9 and 2 with haemophilia B) was investigated. In 12 of 23 haemophiliacs antibodies to HIV were detected. All seropositive patients were treated by imported clotting factor concentrates, and cryoprecipitates obtained by local donors. Six HIV positive haemophiliacs were in asymptomatic stage of HIV infection, and six others were in persistent generalized lymphadenopathy stage. HIV positive haemophiliacs showed a decreased number of CD4 and CD2 lymphocytes, inversed CD4/CD8 lymphocytes ratio, anergy to skin tests, decreased NK (natural killer), cell cytoxic activity, increased IgG and increased immune complexes. HIV negative haemophiliacs showed no different immunologic abnormality than healthy controls. Our results also showed differences in the degree and type of immunological abnormalities depending on different stages of HIV infection. Haemophiliacs in asymptomatic stage of HIV infection showed qualitative abnormalities of T cell immunity, manifested with decreased NK cells cytotoxic activity and anergy to skin tests, while haemophiliacs in persistent generalized lymphadenopathy stage, besides qualitative, showed quantitative abnormalities of T cell immunity, manifested with decreased lymphocyte subpopulations (CD2, CD3, CD4). Immunological disorders observed in our haemophilia patients were in direct correlation with the presence of anti HIV antibodies in peripheral blood, and we suppose that they may be attributed to HIV infection rather than to chronic antigenic stimulation with foreign proteins in blood products.

Recovery from herpes simplex virus type-1 hepatitis in a female adult

A study of one case of herpes simplex hepatitis in an adult woman is presented. The clinical feature and laboratory findings were typical for acute hepatitis in a febrile patient without herpetic mucocutaneous lesions. The evidence of high IgM antibody titer in serum against herpes simplex virus and confirmation of the herpes simplex virus hepatitis by immunofluorescent microscopy after liver biopsy helped us establish the diagnosis. After 3-months the patient recovered.

Herpes simplex virus infection in women with previous spontaneous abortion

We have carried out a retrospective clinical investigation of 45 women in the first and second trimester of pregnancy aiming to demonstrate the role of genital HSV infection in the genesis of spontaneous abortion (miscarriage). Latent HSV infection was diagnosed using the microneutralization test; asymptomatic HSV vaginal or cervical shedding was diagnosed with indirect immunofluorescence and cytological-Papanicolau staining. The results showed that the highest incidence of latent HSV type 2 infection (64%) occurred in women who had one or more spontaneous abortions, whereas this type of infection was found in only 5% of pregnant women of the control group. The incidence of asymptomatic cervical HSV type 2 infection was also considerably higher in patients with a history of spontaneous abortions. Our results indicate a possible aetiological connection between HSV and spontaneous abortion.

Herpesvirus hominis (HVH) infection in women with preterm labor

A possible etiologic relationship between maternal asymptomatic genital HVH infection and pre-term labor was discussed on the base of the results of the investigation performed in this study. Latent HVH infection was diagnosed by the test of microneutralization. Asymptomatic HVH vaginal and cervical shedding was investigated by indirect immunofluorescence and cytologically. The incidence of latent HVH type 2 infection was higher in women with previous pre-term labor than in the control group. The obtained difference appeared to be statistically significant. The comparison of HVH type 2 asymptomatic cervical infection of the examined and the control group shows that it lies on the boundary of statistical significance. It means that further research of the subject is needed including prospective virologic investigations with the aim of detecting active HVH infections at the time of pre-term labor. Concerning the increasing significance of genital HVH infections in our environment, it seems reasonable to aim diagnostic efforts at the determination of both latent and active HVH infections, in order to reduce the incidence of pre-term labor and the perinatal morbidity and mortality rates by use of the appropriate preventive and therapeutic measures.

[Cervical infection as a cause of female sterility]

The study covered 116 infertile women in whom other etiological factors were ruled out, while 55 fertile patients served as controls. In infertile women, within the ovulation term, microorganisms of intestinal origin were isolated in 42.24%. Banal flora was present in 24.13%, while the saprophytic flora was verified in 21.5%. Culture media remained sterile in 8.62%. In the control group the differences are self, evident: the pathogenic flora was present only in 12.18% and the culture media remained sterile in 38.18%. In spite of the findings in the endocervix, the cervix was macroscopically normal in 54.31% of infertile persons. In patients from the control group, with regard to deliveries, pathologic changes of the portion were present in a higher percentage. The number of spermagglutinins in the serum was somewhat higher in patients from the infertile group in whom the infection of the endocervix was observed.