Background
Our understanding of the mother-to-child transfer of
serotype-specific pneumococcal antibodies is limited in non-immunized,
HIV-positive women.
Methods
We compared geometric mean antibody concentrations (GMCs), geometric
mean transplacental cord:maternal ratios (GMRs) and proportions of samples
with protective antibody concentration (≥ 0.35 μg/ml) to
serotypes 1, 4, 5, 6B, 9V, 14, 18C, 19F, 23F between 74 HIV-infected and 98
HIV-uninfected mother-infant pairs who had not received pneumococcal
immunization in South Asia. Multivariable analysis was performed to assess
the influence of HIV on protective antibody concentrations.
Results
HIV-infected mothers and their infants exhibited lower GMCs and GMRs
than their uninfected counterparts. This was significant for all serotypes
except maternal GMC to serotype 1 and GMR for serotype 6B. In multivariate
analysis, HIV was significantly associated with reduced odds of having
protective pneumococcal IgG levels; 56–73% reduction for 3 maternal
serotypes (4, 5, 23F) and 62–90% reduction for all cord samples
except serotype 6B.
Conclusions
Maternal HIV infection is associated with lower levels of maternal
pneumococcal antibodies and disproportionately lower cord antibodies,
relative to maternal antibodies, suggesting that HIV infection compromises
transplacental transfer. Reassessment of maternal and/or infant pneumococcal
immunization strategies is needed in HIV-infected women and their
infants.