Objective:

This study aims to determine the concentration of complement factor I (CFI) and complement component 4b (C4b) in normotensive (N) pregnant women compared to women with preeclampsia (PE) and human immunodeficiency virus (HIV).

Materials and Methods:

The study population consisted of preeclamptic (n=38) and normotensive (n=38) pregnant women, who were further stratified by HIV status into HIV-positive (n=19) and HIV-negative (n=19) groups. Serum levels of CFI and C4b were determined using the Bio-Plex multiplex immunoassays. Data analysis was conducted using Stata (version 12) and Graphpad Prism (8.0.1).

Results:

A statistically significant downregulation of C4b was noted in the N+ve vs. N-ve, PE+ve in comparison with the N+ve group (p=0.0001) and in PE+ve compared to the PE-ve pregnancies. CFI levels were significantly upregulated in the N+ve vs. N-ve groups (p=0.004) and downregulated in PE+ve compared to N+ve and in PE+ve vs. PE-ve groups (p=0.004). Significant positive associations were noted for C4b with parity, between the PE-ve and N+ve groups (r=0.47; p=0.04), and for CFI in the PE+ve group (r=0.68; p=0.0001). Negative significant associations were noted between C4b and systolic blood pressure (r=-0.53, p=0.01) and C4b and diastolic blood pressure (r=-0.78, p=0.0001). CFI also showed negative association with parity (r=-0.48, p=0.03).

Conclusion:

This innovative study demonstrates a decline of C4b and CFI levels in PE+ve, compared to N+ve pregnancies. It is plausible that the downregulation may be attributed to complement mediated virolysis emanating from C3 convertase dysregulation in PE comorbidity with HIV infection.

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