The Effect of Intermittent Preventive Treatment during Pregnancy on Malarial Antibodies Depends on HIV Status and Is Not Associated with Poor Delivery Outcomes

Abstract

The IPTp-associated reduction in antibodies in HIV-infected women, but not in HIV-uninfected women, may reflect a higher efficacy of the intervention in preventing malaria among HIV-positive mothers. This reduction did not translate into an enhanced risk of malaria-associated morbidity in mothers and infants. Trial registration. Clinicaltrials.gov identifier NCT00209781.

Age-Dependent IgG Subclass Responses to Plasmodium falciparum EBA-175 Are Differentially Associated with Incidence of Malaria in Mozambican Children

“…Indeed, in the crude analysis, a common finding was that high antibody levels were associated with an increased risk of malaria. In another study in Manhiça, high maternal and fetal IgG levels were associated with a higher risk of malaria in the infant (49), and this was consistent with the findings of other similar studies (30,43). Nevertheless, when the analyses were adjusted for prior malaria episodes, the association disappeared, indicating that the main risk factor was the occurrence of previous episodes and that the antibodies were mere markers of the prior exposure.…”

“…Transplacental IgG subclass transfer is also influenced by malaria parasite infection and maternal hypergammaglobulinemia (35). During placental malaria, there is production of more IgG in the mother (49) and it appears that less IgG1 is transferred to the fetus, while IgG3 seems unaffected (35).…”

Persistence of Plasmodium falciparum Parasites in Infected Pregnant Mozambican Women after Delivery

“…Malaria susceptibility in pregnant women has been explained as a consequence of the lack of antibodies blocking adhesion of infected erythrocytes to placental CSA (14). However, immunity to CSA-binding parasites and reduced risk of poor delivery outcomes have been associated in some studies (9,14,41) but not in others (4,6,11,39). Furthermore, the high incidence of malaria episodes observed a few weeks after delivery (8,15,34) suggests that other mechanisms may be also involved in the susceptibility of pregnant women to malaria.…”

Immune responses during gestational malaria: a review of the current knowledge and future trend of research

“…Moreover, a significant number of women at delivery have antibodies against placental parasites, but their placentas remain infected [111,116]. Several studies have failed to show an association between levels of anti-CSA binding IgG and a reduced frequency of adverse consequences of malaria during pregnancy [122][123][124].…”