Serum metabolome signatures characterizing co-infection of Plasmodium falciparum and HBV in pregnant women

Abstract

Background Pregnant women are among the most susceptible groups to infectious diseases. In Northern Ghana, Plasmodium falciparum (P. falciparum) and hepatitis B virus (HBV) co-infection is prevalent among pregnant women. and has been found to induce an augmented inflammatory immune response and aggravate liver damage. Objective Mono-infection with either of these pathogens results in unique metabolic alterations. Thus, we aimed to explicate the effects of co-infection of these two pathogens on the metabolome signatures of pregnant women. This could give an indication to the metabolic pathways that are impacted and provide useful prognostic or diagnostic markers. Methods Using MS/MS-based targeted metabolomic approach, we determined the serum metabolome in pregnant women with either P. falciparum mono-infection, HBV mono-infection, P. falciparum and HBV co-infection or in un-infected (control) women. Results We observed that concentrations of sphingolipids were significantly decreased in subjects with P. falciparum mono-infection. Whereas amino acids and phospholipids were decreased in subjects with HBV mono-infection. Co-infection of the two pathogens was found to be characterized distinctively by reduced concentrations of phospholipids and hexoses (mostly glucose). Additionally, co-infection was characterized by altered pathways that contribute to redox homeostasis. Overall, PC ae C40:1 was found to be a good discriminatory metabolite for the co-infection group. Conclusions Put together, the metabolite PC ae C40:1, could serve as a potential biomarker for characterizing the co-infection, and can further be explored for use in diagnosis and treatment of malaria and chronic hepatitis B co-morbidity as well as distinguishing co-infections from cases of mono-infections.