Document Detail

Maternal HIV infection and antibody responses against vaccine-preventable diseases in uninfected infants.
MedLine Citation:
PMID:  21304083     Owner:  NLM     Status:  MEDLINE    
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 pneumococcus (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.
Christine E Jones; Shalena Naidoo; Corena De Beer; Monika Esser; Beate Kampmann; Anneke C Hesseling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  305     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-09     Completed Date:  2011-02-14     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  576-84     Citation Subset:  AIM; IM    
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MeSH Terms
Antibodies, Bacterial / blood*
Antibody Formation*
Case-Control Studies
Cohort Studies
HIV Infections / immunology*
Hepatitis B Surface Antigens / blood
Immunity, Maternally-Acquired / immunology*
Infant, Newborn
Maternal-Fetal Exchange
Pregnancy Complications, Infectious / immunology*
South Africa
Vaccines / immunology*
Young Adult
Grant Support
MC_UP_A900_1115//Medical Research Council; MC_UP_A900_1122//Medical Research Council; //Wellcome Trust
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Hepatitis B Surface Antigens; 0/Vaccines
Comment In:
JAMA. 2011 May 18;305(19):1964; author reply 1964-5   [PMID:  21586709 ]

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