Neonatal Tetanus Immunity in Nigeria: The Effect of HIV Infection on Serum Levels and Transplacental Transfer of Antibodies

Background. Tetanus toxoid immunisation of pregnant mother has remained the most effective strategy in eliminating neonatal tetanus. Impaired production and/or transplacental transfer of antibodies may affect the effectiveness of this strategy. We studied the effect of maternal HIV infection on serum levels and transplacental transfer of anti-tetanus antibodies.Methods. A total of 162 mother-baby paired serum samples were taken and analysed for anti-tetanus antibody levels using ELISA. Maternal HIV status was also determined by double ELISA technique. Maternal TT vaccination status was also documented.Results. Thirty-eight (23.5%) mothers and 41 (25.3%) babies were seronegative, out of whom 8 mothers were HIV positive and 9 babies were HIV exposed. HIV infected mothers and HIV exposed infants were, respectively, 16.27 times (OR = 16.27, 95% CI = 3.28 to 80.61) and 33.75 times (OR = 33.75, 95% CI = 4.12 to 276.40) more likely to be seronegative for anti-tetanus antibody. Similarly, HIV positive mother-newborn pairs were 7.46 times more likely to have a poor transplacental transfer of tetanus antibodies (OR = 7.46, 95% CI = 1.96 to 28.41).Conclusions. Maternal HIV infection is associated with impaired maternofoetal transfer of anti-tetanus antibodies and seronegativity among mothers and their newborns. Hence, this may hinder efforts to eliminate neonatal tetanus.

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Influence of maternal HIV infection on fetal thymus size

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0060 ◽

2019 ◽

Vol 48 (1) ◽

pp. 67-73

Author(s):

Clara L. Gasthaus ◽

Ralf Schmitz ◽

Kerstin Hammer ◽

Kathrin Oelmeier de Murcia ◽

Maria K. Falkenberg ◽

...

Keyword(s):

Hiv Infection ◽

Fetal Outcome ◽

Hiv Positive ◽

Control Group ◽

Fetal Thymus ◽

Hiv Positive Mothers ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Hiv Exposed ◽

Thymus Size

AbstractObjectiveTo reveal the effect of a maternal human immunodeficiency virus (HIV) infection on the fetal thymus size.MethodsThe sonographic fetal thymus size was measured retrospectively in 105 pregnancies with maternal HIV infection and in 615 uncomplicated singleton pregnancies. The anteroposterior thymic and the intrathoracic mediastinal diameter were determined in the three-vessel view and their quotient, the thymic-thoracic ratio (TT ratio), was calculated. The study group was subdivided into three groups by the maternal viral load on the date of ultrasound (<50 cop./mL, 50–1000 cop./mL, >1000 cop./mL). Furthermore, an association between prognostic factors of the HIV infection such as the lymphocyte count, CD4/CD8 ratio, HIV medication and the thymus size, was investigated using correlation analyses.ResultsFetal thymus size in pregnancies of HIV-positive mothers showed to be noticeably larger than in uncomplicated pregnancies. The mean TT ratio in the HIV-positive group was 0.389 and in the control group 0.345 (P < 0.001). There was no association between any maternal HIV parameter or medication and the size of the thymus gland.ConclusionMaternal HIV infection was associated with an increased fetal thymus size. Further consequences of intrauterine HIV exposure for fetal outcome and the development of the immune system of HIV-exposed uninfected (HEU) infants must be discussed.

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Evidence of Impact of Maternal HIV Infection on Immunoglobulin Levels in HIV-Exposed Uninfected Children

AIDS Research and Human Retroviruses ◽

10.1089/aid.2009.0241 ◽

2010 ◽

Vol 26 (9) ◽

pp. 967-975 ◽

Cited By ~ 23

Author(s):

Madeleine Bunders ◽

Lucy Pembrey ◽

Taco Kuijpers ◽

Marie-Louise Newell

Keyword(s):

Hiv Infection ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Hiv Exposed ◽

Evidence Of Impact ◽

Immunoglobulin Levels ◽

Exposed Uninfected

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Impact of maternal HIV infection on pregnancy outcomes in southwestern China – a hospital registry based study

Epidemiology and Infection ◽

10.1017/s0950268818003345 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 2

Author(s):

M. Yang ◽

Y. Wang ◽

Y. Chen ◽

Y. Zhou ◽

Q. Jiang

Keyword(s):

Immune Deficiency ◽

Hiv Infection ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Southwestern China ◽

Hiv Positive ◽

Rural Residence ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Adverse Pregnancy

AbstractGlobally, human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) continues to be a major public health issue. With improved survival, the number of people living with HIV/AIDS is increasing, with over 2 million among pregnant women. Investigating adverse pregnant outcomes of HIV-infected population and associated factors are of great importance to maternal and infant health. A cross-sectional data collected from hospital delivery records of 4397 mother–infant pairs in southwestern China were analysed. Adverse pregnant outcomes (including low birthweight/preterm delivery/low Apgar score) and maternal HIV status and other characteristics were measured. Two hundred thirteen (4.9%) mothers were HIV positive; maternal HIV infection, rural residence and pregnancy history were associated with all three indicators of adverse pregnancy outcomes. This research suggested that maternal population have high prevalence in HIV infection in this region. HIV-infected women had higher risks of experiencing adverse pregnancy outcomes. Rural residence predisposes adverse pregnancy outcomes. Findings of this study suggest social and medical support for maternal-infant care needed in this region, selectively towards rural areas and HIV-positive mothers.

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Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda

Public Health Nutrition ◽

10.1017/s1368980013000499 ◽

2013 ◽

Vol 16 (9) ◽

pp. 1548-1557 ◽

Cited By ~ 29

Author(s):

Lawrence Muhangi ◽

Swaib A Lule ◽

Harriet Mpairwe ◽

Juliet Ndibazza ◽

Moses Kizza ◽

...

Keyword(s):

Hiv Infection ◽

Maternal Education ◽

Hiv Transmission ◽

Growth Data ◽

Poor Growth ◽

Growth Outcomes ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Hiv Exposed ◽

Living Children

AbstractObjectiveTo assess the associations between maternal HIV infection and growth outcomes of HIV-exposed but uninfected infants and to identify other predictors for poor growth among this population.DesignWithin a trial of de-worming during pregnancy, the cohort of offspring was followed from birth. HIV status of the mothers and their children was investigated and growth data for children were obtained at age 1 year. Length-for-age, weight-for-age and weight-for-length Z-scores were calculated for each child; Z-scores <−2 were defined as stunting, underweight and wasting, respectively.SettingThe study was conducted in Entebbe municipality and Katabi sub-county, Uganda.SubjectsThe sample consisted of 1502 children aged 1 year: HIV-unexposed (n 1380) and HIV-exposed not infected (n 122).ResultsPrevalence of stunting, underweight and wasting was 14·2 %, 8·0 % and 3·9 %, respectively. There was evidence for an association between maternal HIV infection and odds of being underweight (adjusted OR = 2·32; 95 % CI 1·32, 4·09; P = 0·006) but no evidence for an association with stunting or with wasting. Young maternal age, low maternal education, low birth weight, early weaning and experiencing a higher number of episodes of malaria during infancy were independent predictors for stunting and underweight. A higher number of living children in the family was associated with wasting.ConclusionsMaternal HIV infection was associated with being underweight in HIV-exposed uninfected infants. The success of programmes for prevention of mother-to-child HIV transmission means that an increasing number of infants will be born to HIV-infected women without acquiring HIV. Therefore, viable nutritional interventions need to be identified for this population.

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Placental Transfer of Respiratory Syncytial Virus Antibody Among HIV-Exposed, Uninfected Infants

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piz056 ◽

2019 ◽

Vol 9 (3) ◽

pp. 349-356

Author(s):

Sweta M Patel ◽

Sabelle Jallow ◽

Sefelani Boiditswe ◽

Shabir A Madhi ◽

Kristen A Feemster ◽

...

Keyword(s):

Hiv Infection ◽

Neutralizing Antibodies ◽

Placental Transfer ◽

Immunodeficiency Virus ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Syncytial Virus ◽

Hiv Exposed ◽

Antibody Levels ◽

Exposed Uninfected

Abstract Background Maternal human immunodeficiency virus (HIV) infection is associated with lower placental transfer of antibodies specific to several childhood pathogens. Our objective for this study was to evaluate the effect of maternal HIV infection on the placental transfer of respiratory syncytial virus (RSV)-neutralizing antibodies. Methods We conducted a cross-sectional study of mothers and their newborn infants at a tertiary hospital in Gaborone, Botswana, between March 2015 and December 2015. We measured serum RSV antibody levels by using a microneutralization assay. We used multivariable linear regression to evaluate the effect of maternal HIV infection on maternal RSV antibody levels, placental transfer of RSV antibodies, and newborn RSV antibody levels. Results Of 316 mothers, 154 (49%) were infected with HIV. The placental transfer ratios for RSV antibodies to HIV-exposed, uninfected (HEU) and HIV-unexposed, uninfected infants were 1.02 and 1.15, respectively. The geometric mean titer (95% confidence interval) of RSV-neutralizing antibodies was 2657 (2251–3136) among HEU newborns and 2911 (2543–3331) among HIV-unexposed, uninfected newborns. In multivariable analyses, maternal HIV infection was associated with lower placental transfer of RSV antibodies (P = .02) and a lower level of RSV antibodies among newborns (P = .002). Among HEU newborns, higher birth weight (P = .004) and an undetectable maternal antenatal viral load (P = .01) were associated with more effective placental transfer of RSV antibodies. Conclusions Maternal human immunodeficiency virus (HIV) infection is associated with lower mother-to-fetus transfer of serum RSV-neutralizing antibodies. HEU infants should be prioritized for preventive interventions for RSV. Maternal viral suppression through combination antiretroviral therapy has the potential to improve immunity to RSV among HIV-exposed infants.

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Impact of Maternal HIV Infection and Placental Malaria on the Transplacental Transfer of Influenza Antibodies in Mother–Infant Pairs in Malawi, 2013–2014

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz383 ◽

2019 ◽

Vol 6 (10) ◽

Author(s):

Antonia Ho ◽

Gugulethu Mapurisa ◽

Mwayiwawo Madanitsa ◽

Linda Kalilani-Phiri ◽

Steve Kamiza ◽

...

Keyword(s):

Virus Infection ◽

Hiv Infection ◽

Malaria Transmission ◽

Influenza A ◽

Placental Malaria ◽

Transplacental Transfer ◽

Maternal Hiv ◽

Maternal Hiv Infection ◽

Antibody Levels ◽

The Impact

Abstract Background Maternal influenza vaccination protects infants against influenza virus infection. Impaired transplacental transfer of influenza antibodies may reduce this protection. Methods We conducted a cross-sectional study of influenza vaccine–naïve pregnant women recruited at delivery from Blantyre (urban, low malaria transmission) and Chikwawa (rural, high malaria transmission) in Southern Malawi. HIV-infected mothers were excluded in Chikwawa. Maternal and cord blood antibodies against circulating influenza strains A/California/7/2009, A/Victoria/361/2011, B/Brisbane/60/2008, and B/Wisconsin/1/2010 were measured by hemagglutination inhibition (HAI). We studied the impact of maternal HIV infection and placental malaria on influenza antibody levels in mother–infant pairs in Blantyre and Chikwawa, respectively. Results We included 454 mother–infant pairs (Blantyre, n = 253; Chikwawa, n = 201). HIV-infected mothers and their infants had lower seropositivity (HAI titer ≥1:40) against influenza A(H1N1)pdm09 (mothers, 24.3 vs 45.4%; P = .02; infants, 24.3 vs 50.5%; P = .003) and A(H3N2) (mothers, 37.8% vs 63.9%; P = .003; infants, 43.2 vs 64.8%; P = .01), whereas placental malaria had an inconsistent effect on maternal and infant seropositivity. In multivariable analyses, maternal HIV infection was associated with reduced infant seropositivity (A(H1N1)pdm09: adjusted odds ratio [aOR], 0.34; 95% confidence interval [CI], 0.15–0.79; A(H3N2): aOR, 0.43; 95% CI, 0.21–0.89). Transplacental transfer was not impaired by maternal HIV or placental malaria. Conclusions Maternal HIV infection influenced maternal antibody response to influenza A virus infection, and thereby antibody levels in newborns, but did not affect transplacental antibody transfer.

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