Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants
Date
2011
Authors
Jones C.E.
Naidoo S.
De Beer C.
Esser M.
Kampmann B.
Hesseling A.C.
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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. ©2011 American Medical Association. All rights reserved.
Description
Keywords
bacterial antigen, Haemophilus influenzae vaccine, hepatitis B surface antigen, pertussis vaccine, Pneumococcus vaccine, tetanus antibody, tetanus toxoid, antibody blood level, antibody response, antibody titer, article, birth, Bordetella pertussis, controlled study, enzyme linked immunosorbent assay, female, Haemophilus influenzae type b, human, Human immunodeficiency virus infection, infant, major clinical study, maternal disease, placental transfer, priority journal, South Africa, Streptococcus pneumoniae, vaccination, Antibodies, Bacterial, Antibody Formation, Case-Control Studies, Cohort Studies, Female, Hepatitis B Surface Antigens, HIV Infections, Humans, Immunity, Maternally-Acquired, Infant, Newborn, Male, Maternal-Fetal Exchange, Pregnancy, Pregnancy Complications, Infectious, South Africa, Vaccination, Vaccines, Young Adult
Citation
JAMA - Journal of the American Medical Association
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6
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