Maternal HIV Infection and Antibody Responses Against Vaccine-Preventable Diseases in Uninfected Infants

Jones, Christine E; Naidoo, Shalena; Beer, Corena de; Esser, Monika; Kampmann, Beate; Hesseling, Anneke C.

doi:10.1001/jama.2011.100

Cited by 219 publications

(217 citation statements)

References 33 publications

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“…We have recently conducted observational studies to understand the impact of maternal infection on immune priming and vaccine responses in the neonate. In a South African mother -infant cohort, we showed that maternal HIV infection is associated with significantly lower concentrations of specific antibody to vaccine antigens in HIV-exposed, uninfected infants at birth compared with infants not exposed to HIV; however, HIV exposure did not affect the infant's ability to mount a robust response to infant immunization [23]. We also examined the consequences of maternal HIV infection and/or sensitization to mycobacteria and found that HIVexposed, uninfected infants have normal responses to BCG vaccination administered at birth [24].…”

Section: The Impact Of Maternal or Infant Co-infections On Vaccine Rementioning

confidence: 87%

Factors influencing innate immunity and vaccine responses in infancy

Kampmann

Jones

2015

Phil. Trans. R. Soc. B

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Despite significant progress in reducing the burden of mortality in children under the age of five, reducing mortality in newborns remains a major challenge. Infection plays a significant role in infant deaths and interventions such as early vaccination or antenatal immunization could make a significant contribution to prevention of such deaths. In the last few years, we have gained new insights into immune ontogeny and are now beginning to understand the impact of vaccines, nutrition and environmental factors on ‘training′ of the immune response in early life. This review article sets out to explain why vaccine responses can be heterogeneous between populations and individuals by providing examples chosen to illustrate the impact of host, pathogen and environmental factors on shaping the immune ‘interactome′ in young children.

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Section: The Impact Of Maternal or Infant Co-infections On Vaccine Rementioning

confidence: 87%

Factors influencing innate immunity and vaccine responses in infancy

Kampmann

Jones

2015

Phil. Trans. R. Soc. B

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“…This notion has been supported by several studies, which documented low vaccine-specific antibody titers in HIV-infected mothers and attenuated vaccine-specific antibody levels in HEU compared to HUU infants (21)(22)(23)(24). These differences have been ascribed to a compromise in maternally transferred antibodies, differing antibody half lives (24), and altered responses to vaccination (21,22). To date, however, studies have only investigated vaccine responses in either short-term cohorts or in cross-sectional analysis (21-24), thereby not addressing long-term vaccine-induced immunity in HEU infants (14).…”

mentioning

confidence: 80%

“…To this end, we established a birth cohort study in South Africa, a country with an antenatal HIV prevalence of 30% (25), and monitored HEU and HUU infants from 2 weeks up to 2 years of life (12), evaluating their vaccine-specific immune responses. Based on the published literature (21,22,24), we expected to find lower prevaccine-specific antibody titers in the HEU than in the HUU infants, followed by a higher level of response to certain vaccines in HEU than in HUU infants after vaccination. However, given the lack of data, we were not able to predict HEU infants' immune response to booster doses and the longevity of the resulting immune response.…”

mentioning

confidence: 99%

Antibody Responses to Vaccination among South African HIV-Exposed and Unexposed Uninfected Infants during the First 2 Years of Life

Reikie

Naidoo

Ruck

et al. 2013

Clin Vaccine Immunol

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e HIV-exposed but uninfected (HEU) infants born to HIV-infected mothers from areas in the world with a high burden of infectious disease suffer higher infectious morbidity and mortality than their HIV unexposed uninfected (HUU) peers. Vaccination provides protection from infection. The possibility exists that altered response to vaccination contributes to the higher rate of infection in HEU than in HUU infants. While short-term, cross-sectional studies support this notion, it is unclear whether or not HEU infants develop long-term protective immune responses following the WHO extended program on immunization (EPI).Vaccine-specific antibody responses were compared between HEU and HUU infants from 2 weeks until 2 years of age in a longitudinal South African cohort. Total IgG and antibodies specific for Bordetella pertussis, Haemophilus influenzae type b (Hib), tetanus toxoid, hepatitis B virus (HepB), and measles virus were measured at multiple time points throughout the first 2 years of life. Prevaccine antibodies (maternal antibodies passively acquired) specific for tetanus were lower in HEU than in HUU infants, while prevaccine antibodies to HepB were higher in HEU than in HUU infants. Both groups responded similarly to tetanus, Hib, and HepB vaccination. HEU demonstrated stronger pertussis vaccine responses, developing protective titers 1 year earlier than HUU patients, and maintained higher anti-tetanus titers at 24 months of age. Vaccine-induced antibodies to measles virus were similar in both groups at all time points. Our results suggest that the current EPI vaccination program as practiced in South Africa leads to the development of vaccine-specific antibody responses that are equivalent in HEU and HUU infants. However, our data also suggest that a large fraction of both HEU and HUU South African infants have antibody titers for several infectious threats that remain below the level of protection for much of their first 2 years of life.

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“…[24] A 2007 antenatal study comparing 1 420 HIV-positive and negative mothers noted higher anti-HBcoreAb positivity (39.2% v. 30.1%) in HIV-infected women, while 6.2% were HBsAg-positive. [25] HIV also reduces transfer of maternal anti-HBs. Only 21% of HIVexposed v. 54% of unexposed babies had protective levels of anti-HBs, suggesting that 79% of babies born to HIV-positive mothers have no protective anti-HBs until after the first hepatitis B vaccination at 6 weeks of age.…”

Section: Vaccinationmentioning

confidence: 99%

Preventing hepatitis B and hepatocellular carcinoma in South Africa: The case for a birth-dose vaccine

Spearman

Sonderup

2014

S Afr Med J

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Maternal HIV Infection and Antibody Responses Against Vaccine-Preventable Diseases in Uninfected Infants

Abstract: Among South African infants, antenatal HIV exposure was associated with lower specific antibody responses in exposed uninfected infants compared with unexposed infants at birth, but with robust responses following routine vaccination.

Cited by 219 publications

References 33 publications

Factors influencing innate immunity and vaccine responses in infancy

Factors influencing innate immunity and vaccine responses in infancy

Antibody Responses to Vaccination among South African HIV-Exposed and Unexposed Uninfected Infants during the First 2 Years of Life

Preventing hepatitis B and hepatocellular carcinoma in South Africa: The case for a birth-dose vaccine

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