293
secretion3-S is active and spontaneous (antigen or mitogen is persistent in all clinical stages of HIV-1 infection. In our experience these peripheral blood supernatants always remain negative in enzyme immunoassays and WB when the corresponding sera show anti-gag only patterns (ie, WB indeterminate).6 This allows us to eliminate HIV-1 seroconversion
independent) and
in ambiguous
cases.
J. DUCOS J. P. VENDRELL Immunology Laboratory, CHRU Lapeyronie, 34059 Montpellier, France
M. SEGONDY I. PETRIS M. F. HUGUET A. SERRE
1. Van der Poel
CL, Lelie PN, Reesink HW, et al. Blood donors with indeterminate anti-p24 gag reactivity in HIV-1 western blot/absence of infectivity to transfused patients and in virus culture. Vox Sang 1989; 56: 162-67. 2 Lefrère JJ, Couroucé AM, et al. Follow-up of subjects with isolated and persistent anti-core (antip24 or antip17). AIDS 1988; 2: 287-90. 3. Amadori A, de Rossi A, Faulkner WP, Chieco-Bianchi L. Spontaneous in vitro production of virus specific antibody by lymphocytes from HIV infected subjects. Clin Immunol Immunopathol 1988; 46: 342. 4 Lee F, Nahmias A, Lowery S, et al. Elispot: a new approach to study the dynamics of virus-immunosystem interaction for diagnosis and monitoring of HIV infection. AIDS Res 1989; 5: 517-23. 5. Vendrell JP, Ducos J, Rabesandratana H, et al. Specificities of HIV-1 antibodies in serum and in peripheral blood supernatants. Lancet 1989; i: 501. 6. Ducos J, Vendrell JP, Reynes J, Huguet MF, Cannat A, Serre A. Negative results of in vitro tests for HIV antibody production by peripheral blood cells in 12 cases of isolated gag encoded protein positivity. Presented at Vth international conference on AIDS (Montreal, June, 1989).
intake.2 The poor in the Equadorian Andes have many risk factors associated with PIH (young maternal age, primiparity, non-white ethnic status, residence at high altitude, and poor nutritional status5) and consequently an increased frequency of PIH and a high PIH-associated maternal and perinatal mortality rate.6 We suggest that in such populations calcium supplementation or adequate calcium intake during pregnancy is a safe and effective measure to reduce the frequency of PIH. Such treatment should be considered in preference to other proposed measures, such as low-dose aspirin administration.’ The mechanism by which calcium supplementation acts to reduce the risk of PIH is unknown. However, decreased serum ionised calcium concentrations during pregnancy have been recorded.3,g Variation in extracellular calcium concentrations may control the release of prostacyclin9 and nitric oxide (unpublished), both powerful vasodilators and regulators of vascular smoothmuscle tone. Laboratory for Investigations of Metabolism and Nutrition,
Faculty of Medical Science, Central University, Iquique y Sodiro, Quito, Ecuador
1. Narvaez M, Weigel M, Felix C, Lopez A, Lopez-Jaramillo P. The clinical utility of the
2.
3.
4
Dietary calcium supplementation and prevention of pregnancy hypertension SIR,-We have reported the use of the roll-over test in the prediction of pregnancy-induced hypertension (PIH) in an Andean population with a high frequency of PIH.1 This population has a low dietary calcium intake,z and calcium supplementation has proved beneficial in reducing the risk ofPIH.3 We have investigated the effect of calcium in a prospective, randomised, double-blind controlled trial 56 healthy nulliparous women (average age 19’4 ±1-8 years) during pregnancy. The women had a positive roll-over test (rise in diastolic blood pressure of 20 mm Hg or more) at 28-32 weeks’ gestation and were therefore judged at risk of PIH. Each patient was assigned independently in sequence to either 2000 mg elemental calcium daily, from 28-32 weeks’ gestation to delivery, or to starch tablets daily. All patients received standard prenatal care at the Hospital Gineco-Obstetrico Isidro Ayora, Quito. PIH was diagnosed if blood pressure was 140/90 mm Hg or more on at least two occasions 6 h apart. All women completed the study (table). None of the 3 women on calcium in whom PIH developed had proteinuria of over 30 mg/dl, whereas 8 of 24 women on placebo had such proteinuria. Our results show a much lower frequency of PIH, a longer duration of pregnancy, and higher birthweights in the calciumsupplemented group than in the placebo group. The present data thus accord with reports that calcium supplementation during pregnancy attenuates maternal blood pressure in late pregnancy’ and reduces the risk of PIH3in a population with a low calcium EFFECT OF CALCIUM SUPPLEMENTATION IN HIGH-RISK PREGNANCIES IN ANDEAN WOMEN
*t-test; p
secretion3-S is active and spontaneous (antigen or mitogen is persistent in all clinical stages of HIV-1 infection. In our experience these peripheral blood supernatants always remain negative in enzyme immunoassays and WB when the corresponding sera show anti-gag only patterns (ie, WB indeterminate).6 This allows us to eliminate HIV-1 seroconversion
independent) and
in ambiguous
cases.
J. DUCOS J. P. VENDRELL Immunology Laboratory, CHRU Lapeyronie, 34059 Montpellier, France
M. SEGONDY I. PETRIS M. F. HUGUET A. SERRE
1. Van der Poel
CL, Lelie PN, Reesink HW, et al. Blood donors with indeterminate anti-p24 gag reactivity in HIV-1 western blot/absence of infectivity to transfused patients and in virus culture. Vox Sang 1989; 56: 162-67. 2 Lefrère JJ, Couroucé AM, et al. Follow-up of subjects with isolated and persistent anti-core (antip24 or antip17). AIDS 1988; 2: 287-90. 3. Amadori A, de Rossi A, Faulkner WP, Chieco-Bianchi L. Spontaneous in vitro production of virus specific antibody by lymphocytes from HIV infected subjects. Clin Immunol Immunopathol 1988; 46: 342. 4 Lee F, Nahmias A, Lowery S, et al. Elispot: a new approach to study the dynamics of virus-immunosystem interaction for diagnosis and monitoring of HIV infection. AIDS Res 1989; 5: 517-23. 5. Vendrell JP, Ducos J, Rabesandratana H, et al. Specificities of HIV-1 antibodies in serum and in peripheral blood supernatants. Lancet 1989; i: 501. 6. Ducos J, Vendrell JP, Reynes J, Huguet MF, Cannat A, Serre A. Negative results of in vitro tests for HIV antibody production by peripheral blood cells in 12 cases of isolated gag encoded protein positivity. Presented at Vth international conference on AIDS (Montreal, June, 1989).
intake.2 The poor in the Equadorian Andes have many risk factors associated with PIH (young maternal age, primiparity, non-white ethnic status, residence at high altitude, and poor nutritional status5) and consequently an increased frequency of PIH and a high PIH-associated maternal and perinatal mortality rate.6 We suggest that in such populations calcium supplementation or adequate calcium intake during pregnancy is a safe and effective measure to reduce the frequency of PIH. Such treatment should be considered in preference to other proposed measures, such as low-dose aspirin administration.’ The mechanism by which calcium supplementation acts to reduce the risk of PIH is unknown. However, decreased serum ionised calcium concentrations during pregnancy have been recorded.3,g Variation in extracellular calcium concentrations may control the release of prostacyclin9 and nitric oxide (unpublished), both powerful vasodilators and regulators of vascular smoothmuscle tone. Laboratory for Investigations of Metabolism and Nutrition,
Faculty of Medical Science, Central University, Iquique y Sodiro, Quito, Ecuador
1. Narvaez M, Weigel M, Felix C, Lopez A, Lopez-Jaramillo P. The clinical utility of the
2.
3.
4
Dietary calcium supplementation and prevention of pregnancy hypertension SIR,-We have reported the use of the roll-over test in the prediction of pregnancy-induced hypertension (PIH) in an Andean population with a high frequency of PIH.1 This population has a low dietary calcium intake,z and calcium supplementation has proved beneficial in reducing the risk ofPIH.3 We have investigated the effect of calcium in a prospective, randomised, double-blind controlled trial 56 healthy nulliparous women (average age 19’4 ±1-8 years) during pregnancy. The women had a positive roll-over test (rise in diastolic blood pressure of 20 mm Hg or more) at 28-32 weeks’ gestation and were therefore judged at risk of PIH. Each patient was assigned independently in sequence to either 2000 mg elemental calcium daily, from 28-32 weeks’ gestation to delivery, or to starch tablets daily. All patients received standard prenatal care at the Hospital Gineco-Obstetrico Isidro Ayora, Quito. PIH was diagnosed if blood pressure was 140/90 mm Hg or more on at least two occasions 6 h apart. All women completed the study (table). None of the 3 women on calcium in whom PIH developed had proteinuria of over 30 mg/dl, whereas 8 of 24 women on placebo had such proteinuria. Our results show a much lower frequency of PIH, a longer duration of pregnancy, and higher birthweights in the calciumsupplemented group than in the placebo group. The present data thus accord with reports that calcium supplementation during pregnancy attenuates maternal blood pressure in late pregnancy’ and reduces the risk of PIH3in a population with a low calcium EFFECT OF CALCIUM SUPPLEMENTATION IN HIGH-RISK PREGNANCIES IN ANDEAN WOMEN
*t-test; p
