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Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants

Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants
Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants
Context: Altered immune responses might contribute to the high morbidity and mortality observed in human immunodeficiency virus (HIV)-exposed uninfected infants. Objective: To study the association of maternal HIV infection with maternal- and infant-specific antibody levels to Haemophilus influenzae type b (Hib), pneumococcus, Bordetella pertussis antigens, tetanus toxoid, and hepatitis B surface antigen. Design, Setting, and Participants: A community-based cohort study in Khayelitsha, Western Cape Province, South Africa, between March 3, 2009, and April 28, 2010, of 109 HIV-infected and uninfected women and their infants. Serum samples from 104 women and 100 infants were collected at birth and samples from 93 infants were collected at 16 weeks. Main Outcome Measure: Level of specific antibody in mother-infant pairs at delivery and in infants at 16 weeks, determined by enzyme-linked immunosorbent assays. Results: At birth, HIV-exposed uninfected infants (n=46) had lower levels of specific antibodies than unexposed infants (n=54) did to Hib (0.37 [interquartile range {IQR}, 0.22-0.67] mg/L vs 1.02 [IQR, 0.34-3.79] mg/L; P<.001), pertussis (16.07 [IQR, 8.87-30.43] Food and Drug Administration [FDA] U/mL vs 36.11 [IQR, 20.41-76.28] FDA U/mL; P<.001), pneumococcus (17.24 [IQR, 11.33-40.25] mg/L vs 31.97 [IQR, 18.58-61.80] mg/L; P=.02), and tetanus (0.08 [IQR, 0.03-0.39] IU/mL vs 0.24 [IQR, 0.08-0.92] IU/mL; P=.006). Compared with HIV-uninfected women (n=58), HIV-infected women (n=46) had lower specific antibody levels to Hib (0.67 [IQR, 0.16-1.54] mg/L vs 1.34 [IQR, 0.15-4.82] mg/L; P=.009) and pneumococcus (33.47 [IQR, 4.03-69.43] mg/L vs 50.84 [IQR, 7.40-118.00] mg/L; P=.03); however, no differences were observed for antipertussis or antitetanus antibodies. HIV-exposed uninfected infants (n=38) compared with HIV-unexposed infants (n=55) had robust antibody responses following vaccination, with higher antibody responses to pertussis (270.1 [IQR, 84.4-355.0] FDA U/mL vs 91.7 [IQR, 27.9-168.4] FDA U/mL; P=.006) and pneumoccocus (47.32 [IQR, 32.56-77.80] mg/L vs 14.77 [IQR, 11.06-41.08] mg/L; P=.001). Conclusion: 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.
0098-7484
576-584
Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Naidoo, Shalena
401e0a5a-fc05-48f8-9334-d54c6a7533e8
De Beer, Corena
9f88bef6-b114-4b7f-981d-f77e504fd9c5
Esser, Monika
5369785c-3c7d-4216-a60d-71139f53e92e
Kampmann, Beate
4490f5e3-318c-4074-bf69-4a23bd5ec100
Hesseling, Anneke C.
f97382e1-ac66-4c60-aa47-153f2ea687df
Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Naidoo, Shalena
401e0a5a-fc05-48f8-9334-d54c6a7533e8
De Beer, Corena
9f88bef6-b114-4b7f-981d-f77e504fd9c5
Esser, Monika
5369785c-3c7d-4216-a60d-71139f53e92e
Kampmann, Beate
4490f5e3-318c-4074-bf69-4a23bd5ec100
Hesseling, Anneke C.
f97382e1-ac66-4c60-aa47-153f2ea687df

Jones, Christine E., Naidoo, Shalena, De Beer, Corena, Esser, Monika, Kampmann, Beate and Hesseling, Anneke C. (2011) Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants. JAMA, 305 (6), 576-584. (doi:10.1001/jama.2011.100).

Record type: Article

Abstract

Context: Altered immune responses might contribute to the high morbidity and mortality observed in human immunodeficiency virus (HIV)-exposed uninfected infants. Objective: To study the association of maternal HIV infection with maternal- and infant-specific antibody levels to Haemophilus influenzae type b (Hib), pneumococcus, Bordetella pertussis antigens, tetanus toxoid, and hepatitis B surface antigen. Design, Setting, and Participants: A community-based cohort study in Khayelitsha, Western Cape Province, South Africa, between March 3, 2009, and April 28, 2010, of 109 HIV-infected and uninfected women and their infants. Serum samples from 104 women and 100 infants were collected at birth and samples from 93 infants were collected at 16 weeks. Main Outcome Measure: Level of specific antibody in mother-infant pairs at delivery and in infants at 16 weeks, determined by enzyme-linked immunosorbent assays. Results: At birth, HIV-exposed uninfected infants (n=46) had lower levels of specific antibodies than unexposed infants (n=54) did to Hib (0.37 [interquartile range {IQR}, 0.22-0.67] mg/L vs 1.02 [IQR, 0.34-3.79] mg/L; P<.001), pertussis (16.07 [IQR, 8.87-30.43] Food and Drug Administration [FDA] U/mL vs 36.11 [IQR, 20.41-76.28] FDA U/mL; P<.001), pneumococcus (17.24 [IQR, 11.33-40.25] mg/L vs 31.97 [IQR, 18.58-61.80] mg/L; P=.02), and tetanus (0.08 [IQR, 0.03-0.39] IU/mL vs 0.24 [IQR, 0.08-0.92] IU/mL; P=.006). Compared with HIV-uninfected women (n=58), HIV-infected women (n=46) had lower specific antibody levels to Hib (0.67 [IQR, 0.16-1.54] mg/L vs 1.34 [IQR, 0.15-4.82] mg/L; P=.009) and pneumococcus (33.47 [IQR, 4.03-69.43] mg/L vs 50.84 [IQR, 7.40-118.00] mg/L; P=.03); however, no differences were observed for antipertussis or antitetanus antibodies. HIV-exposed uninfected infants (n=38) compared with HIV-unexposed infants (n=55) had robust antibody responses following vaccination, with higher antibody responses to pertussis (270.1 [IQR, 84.4-355.0] FDA U/mL vs 91.7 [IQR, 27.9-168.4] FDA U/mL; P=.006) and pneumoccocus (47.32 [IQR, 32.56-77.80] mg/L vs 14.77 [IQR, 11.06-41.08] mg/L; P=.001). Conclusion: 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.

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Published date: 9 February 2011

Identifiers

Local EPrints ID: 474901
URI: http://eprints.soton.ac.uk/id/eprint/474901
ISSN: 0098-7484
PURE UUID: 9911132a-7fdc-4131-b9bf-d90334f20e0f
ORCID for Christine E. Jones: ORCID iD orcid.org/0000-0003-1523-2368

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Date deposited: 06 Mar 2023 17:58
Last modified: 06 Jun 2024 01:58

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Contributors

Author: Shalena Naidoo
Author: Corena De Beer
Author: Monika Esser
Author: Beate Kampmann
Author: Anneke C. Hesseling

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