The indicators of endogenous intoxication in the dynamic of pregnancy in women with HIV infection

Abstract

Background. Endotoxicosis is a complex pathophysiological process that has a major impact on the mother-placenta-fetus system during pregnancy, and in some cases, is associated with tissue destruction. The human immunodeficiency virus is an aggravating factor that can increase the risk of endotoxicosis during pregnancy. The aim was to assess the level of endogenous intoxication in HIV-positive women during pregnancy by the content of medium-weight molecules in venous blood. Methods. The severity of endogenous intoxication was assessed by the content of medium-weight molecules (MSM) in pregnant women with a HIV-positive status. The study included 33 women aged 23 to 35 years. The indicators were evaluated at 4 points: 6-12, 18-22, 28-32, and 38-40 weeks of pregnancy. Blood plasma was used as the study material. The MSM content was measured by spectrophotometry at λ =238, 254, 260, and 280 nm, followed by the calculation of the distribution coefficients (238/260, 238/280, 280/254). The MSM fraction content was expressed in optical density units. Results. A significant increase in the MSM level was found at λ=260 nm and λ=280 nm at 38-40 weeks compared to 28-32 weeks (p<0.05). The content of MSM280 was higher before childbirth compared to 6-12 week pregnancy (p<0.05). The peptide-nucleotide distribution coefficient (238/260 nm), as well as the aromaticity coefficient (238/280 nm) were lower at 38-40 weeks of pregnancy compared with the first trimester of gestation (p<0.05). Conclusion. The MSM detected at λ=260 nm and 280 nm, as well as the coefficients of aromaticity and the peptide-nucleotide coefficient proved to be sensitive markers for monitoring the level of endogenous intoxication in HIV-positive pregnant women. Measuring MSM in HIV-positive pregnant women can be used not only as an indicator of endogenous intoxication, but also as an indirect indicator of excessive generation of oxygen metabolites and peroxide damage to biological substrates.