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

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dc.contributor.authorJones C.E.
dc.contributor.authorNaidoo S.
dc.contributor.authorDe Beer C.
dc.contributor.authorEsser M.
dc.contributor.authorKampmann B.
dc.contributor.authorHesseling A.C.
dc.date.accessioned2011-05-15T16:16:48Z
dc.date.available2011-05-15T16:16:48Z
dc.date.issued2011
dc.description.abstractContext: 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.
dc.description.versionArticle
dc.identifier.citationJAMA - Journal of the American Medical Association
dc.identifier.citation305
dc.identifier.citation6
dc.identifier.issn00987484
dc.identifier.other10.1001/jama.2011.100
dc.identifier.urihttp://hdl.handle.net/10019.1/13944
dc.subjectbacterial antigen
dc.subjectHaemophilus influenzae vaccine
dc.subjecthepatitis B surface antigen
dc.subjectpertussis vaccine
dc.subjectPneumococcus vaccine
dc.subjecttetanus antibody
dc.subjecttetanus toxoid
dc.subjectantibody blood level
dc.subjectantibody response
dc.subjectantibody titer
dc.subjectarticle
dc.subjectbirth
dc.subjectBordetella pertussis
dc.subjectcontrolled study
dc.subjectenzyme linked immunosorbent assay
dc.subjectfemale
dc.subjectHaemophilus influenzae type b
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectinfant
dc.subjectmajor clinical study
dc.subjectmaternal disease
dc.subjectplacental transfer
dc.subjectpriority journal
dc.subjectSouth Africa
dc.subjectStreptococcus pneumoniae
dc.subjectvaccination
dc.subjectAntibodies, Bacterial
dc.subjectAntibody Formation
dc.subjectCase-Control Studies
dc.subjectCohort Studies
dc.subjectFemale
dc.subjectHepatitis B Surface Antigens
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectImmunity, Maternally-Acquired
dc.subjectInfant, Newborn
dc.subjectMale
dc.subjectMaternal-Fetal Exchange
dc.subjectPregnancy
dc.subjectPregnancy Complications, Infectious
dc.subjectSouth Africa
dc.subjectVaccination
dc.subjectVaccines
dc.subjectYoung Adult
dc.titleMaternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants
dc.typeArticle
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