Reduced Transplacental Transfer of Antimalarial Antibodies in Kenyan HIV-Exposed Uninfected Infants

Abstract

Background Altered neonatal immune responses may contribute to the increased morbidity observed in HIV-exposed but uninfected (HEU) infants compared with HIV-unexposed uninfected (HUU) infants. We sought to examine the effects of prenatal HIV and malaria exposure on maternal and neonatal plasma cytokine profiles and transplacental antibody transfer. Methods Forty-nine HIV+ and 50 HIV- women and their HIV-uninfected neonate pairs from Kenya were assessed. All HIV+ mothers received combination antiretroviral therapy. Maternal plasma and cord blood plasma samples at delivery were tested for 12 cytokines, total IgG, and IgG specific to 4 vaccine antigens and 14 Plasmodium falciparum antigens. Results HIV+ mothers had lower levels of all 12 plasma cytokines at delivery compared with HIV- mothers, but there were no differences between HEU and HUU neonates. There were no differences in the cord-to-maternal ratios (CMRs) of vaccine-specific IgG between HIV+/HEU and HIV-/HUU maternal–neonate pairs. HIV+/HEU maternal–neonate pairs had significantly lower CMRs for 3 antimalarial IgGs—merozoite surface protein 9, circumsporozoite protein, and erythrocyte binding antigen 181—which remained statistically significant after adjustment for malaria in pregnancy. Conclusions In a cohort of optimally treated HIV-infected pregnant women, maternal HIV infection was associated with reduced transplacental transfer of antimalarial antibodies.

Reduced placental transfer of antibodies against microbial and vaccine antigens in HIV-infected women in Mozambique

“…Some studies also found a negative effect on Hib [27, 40, 51] that is not appreciated in our study (although we found reduced IgG1 levels in cord in univariable analyses). However, our results differ from other studies that did not find any effect of HIV status on IgG levels against C. diphtheriae [36] , C. tetani [31, 36], S. pneumoniae [53], HBV [36] and measles [31, 36].…”

“…Placental malaria (PM) has been shown to reduce transplacental transfer of antibodies against tetanus, measles, Streptococcus pneumoniae ( S. pneumoniae ), herpes simplex virus type 1 (HSV-1), RSV and varicella-zoster virus (VZV) [26, 31–33]. However, other studies have shown no impact of PM on transplacental transfer of tetanus, S. pneumoniae, Haemophilus influenzae type b ( Hib ), diphtheria, measles or RSV antibodies [31, 33–36]. The effect of maternal HIV infection is also controversial.…”

“…The effect of maternal HIV infection is also controversial. Some studies demonstrated that HIV infection leads to a reduction of the transplacental transfer of Hib , pertussis, pneumococcus, measles, tetanus and Plasmodium falciparum ( P. falciparum ) specific antibodies [26, 27, 37–39], but others have shown no effect [31, 36, 39–41]. Therefore, there are probably confounding variables that should be considered.…”

IFN-λ4 Genetic Variants Influence Clinical Malaria Episodes in A Cohort of Kenyan Children

“…We used samples and clinical data collected by the Chulaimbo Antenatal Postnatal (CHAP) study, a prospective cohort study conducted in Kisumu, Kenya between 2011 and 2015. Details of this cohort have been described elsewhere [12,13]. Brie y, the study enrolled pregnant women aged 18-45 years presenting for antenatal consultation at Chulaimbo County Hospital (CCH).…”

“…To evaluate whether genetic variants in IFN-λ4 play a role in P. falciparum and upper respiratory tract infection frequency, we analyzed clinical data collected from 122 children that were part of a previously described birth cohort based in Western Kenya where malaria transmission is holoendemic [12,13]. The demographics of this study population, including child gender, birth weight and median number of clinical visits that they had during the 2-year follow-up are described in Table 1.…”