Altered Maternal Antibody Profiles in Women With Human Immunodeficiency Virus Drive Changes in Transplacental Antibody Transfer . (4th March 2022)

• Record Type: Journal Article
• Authors: Dolatshahi, Sepideh; Butler, Audrey L; Siedner, Mark J; Ngonzi, Joseph; Edlow, Andrea G; Adong, Julian; Jennewein, Madeleine F; Atyeo, Caroline; Bassett, Ingrid V; Roberts, Drucilla J; Lauffenburger, Douglas A; Alter, Galit; Bebell, Lisa M
• Is Part Of: Clinical infectious diseases. Volume 75:Number 8(2022)
• Page Start: 1359
• Page End: 1369
• Publication Date: 2022-03-04
• Subjects: immunity -- neonate -- placenta -- Africa -- vertical; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac156
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Human immunodeficiency virus (HIV)–exposed, uninfected (HEU) children have a higher risk of severe infection, but the causes are poorly understood. Emerging data point to altered antibody transfer in women with HIV (WHIV); however, specific perturbations and the influence of antiretroviral therapy (ART) and HIV viremia remain unclear. Methods: We evaluated antigen-specific transplacental antibody transfer across 14 antigens in paired maternal and umbilical cord plasma from 352 Ugandan women; 176 were WHIV taking ART. We measured antigen-specific immunoglobulin G (IgG) sub­class (IgG1, 2, 3, 4) levels and antibody Fcγ receptor (FcγRn, 2a, 2b, 3a, 3b) binding profiles. We used partial least squares discrimi­nant analysis to define antigen-specific transplacental antibody transfer features. Results: Global antibody transfer patterns were similar by maternal HIV serostatus, pointing to effective placental function in WHIV. However, HEU umbilical cord antibody profiles were altered, driven by perturbed WHIV seroprofiles, with higher levels of herpesvirus antibodies ( P < .01 for Epstein-Barr virus, herpes simplex virus) and lower levels of classic vaccine-induced antibodies ( P < .01 for tetanus, polio, Haemophilus influenzae type b), suggesting that umbilical cord antibody profile differences arise from imbalanced WHIV immunity. Abnormal WHIV antibody profiles were associated with HIV viremia, lower CD4 count, and postconception ART initiation ( P = .01). Conclusions: Perturbed immune-dominance profiles in WHIV shift the balance of immunity delivered to neonates. Perturbed HIV-associated maternal antibody profiles are a key determinant of com­promised neonatal immunity. Maternal vaccination interventions may promote transfer of relevant, effective antibodies to protect HEU children against early-life infections. Abstract : Preserved placental antibody transfer function and perturbed immunedominance profiles in women with human immunodeficiency virus (HIV) shift the balance of immunity delivered to neonates. HIV-associated maternal antibody profile changes compromise neonatal immunity, which may be corrected by maternal vaccination interventions to improve transfer.