Objective C-type lectin domain family 2, member D (CLEC2D) is implicated in the immune response. Pre-eclampsia and HIV infection have opposing immune responses. In view of the high prevalence of HIV infection and pre-eclampsia in South Africa, this study assessed the placental immuno-expression of CLEC2D in HIV associated pre-eclampsia. Method Placental tissue was obtained from 60 pregnancies which were categorized according to pregnancy type (pre-eclamptic or normotensive) and HIV status (positive or negative). Immunohistochemistry and morphometric image analysis were used to evaluate placental CLEC2D immuno-expression. Results CLEC2D expression was significantly decreased in the conducting villi of pre-eclamptic vs normotensive placentae ( p = 0.0418) but was increased in the exchange villi, albeit non-significant ( p = 0.4948). HIV positive status intensified placental CLEC2D immuno-expression in conducting ( p = 0.0312) and exchange ( p = 0.0025) villi. CLEC2D expression was significantly different in exchange vs conducting villi (p < 0.0001) and across study groups ( p = 0.0003). Normotensive; HIV negative placentae (control) had a non-significant difference in CLEC2D expression across villi types, however significant difference was noted within the remaining groups: normotensive; HIV positive ( p < 0.05), pre-eclamptic; HIV positive ( p < 0.01 and pre-eclamptic; HIV negative ( p < 0.001). Conclusion The contrasting expression of CLEC2D in HIV infection and pre-eclampsia is demonstrative of the immunosuppressive and pro-inflammatory roles of the respective pathologies. However, this implication may be confounded by highly active anti-retroviral treatment (HAART).

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