Antibodies against pneumococcal capsular polysaccharide in Malawian HIV-positive mothers and their HIV-exposed uninfected children. Issue 4 (2nd April 2016)

• Record Type: Journal Article
• Authors: Baroncelli, Silvia; Galluzzo, Clementina Maria; Mancinelli, Sandro; Andreotti, Mauro; Jere, Haswell; Amici, Roberta; Marazzi, Maria Cristina; Vella, Stefano; Palombi, Leonardo; Giuliano, Marina
• Is Part Of: Infectious diseases. Volume 48:Issue 4(2016:Apr.)
• Page Start: 317
• Page End: 321
• Publication Date: 2016-04-02
• Subjects: HIV exposed infants -- anti-pneumococcal IgG -- passive transfer -- Malawi; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.3109/23744235.2015.1115895
• Languages: English
• ISSNs: 2374-4235

Abstract

Abstract: Background HIV-exposed uninfected children have a higher risk of infection and mortality compared to HIV-unexposed children and the reasons for this vulnerability are still under investigation.Aim : This study aimed to evaluate the influence of maternal HIV parameters on the passive transfer of anti-pneumococcal capsular polysaccharide (PCP) IgG and to determine whether the concentrations of specific IgG might be related to the morbidity and mortality in HIV-exposed uninfected children.Methods One hundred and twenty-six Malawian HIV-infected pregnant women and their uninfected children were studied. Antiretroviral treatment-naive women started a nevirapine-based triple combination regimen from the third trimester of pregnancy until at least 6 months of exclusive breastfeeding. Mother/child pairs were followed until 2 years after delivery. Plasma anti-PCP IgG titers (in mothers at 26 weeks of gestation and in infants at 1 and 6 months) were determined by an enzyme-linked immunosorbent assay. None of these women and children had received any vaccination against pneumococcal polysaccharides.Results Maternal anti-PCP IgG concentration was independent from viral load ( p = 0.848), CD4 count ( p = 0.740) and WHO stage ( p = 0.450). However, the child/mother ratio of anti-PCP IgG measured at 1 month among infants was significantly reduced in pairs whose mothers had HIV-RNA > 10 000 copies/ml ( p = 0.043) and CD4 < 350 cells/μl ( p = 0.090) before antiretroviral therapy (ART). No clear associations between anti-PCP IgG and respiratory-related deaths were found, but respiratory infection episodes were more frequent among children with lower anti-PCP IgG ratio ( p = 0.046).Conclusion This study indicates that HIV pre-ART conditions in mothers may influence the rate of specific immunoglobulins transfer, increasing infants vulnerability to respiratory infections.