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Infants who are exposed to HIV at birth but not infected may have lower antibodies to other diseases
Jones CE. JAMA. 2011;305:576-584.
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A cohort of South African infants exposed to HIV at birth but who did not become infected had lower levels of antibodies to diseases such as pertussis, tetanus and pneumococcus compared with other infants, according to results of a study published online this week.
Christine E. Jones, BMBS, of Imperial College London, and colleagues studied the association of maternal HIV infection with maternal- and infant-specific antibody levels to Haemophilus influenzae type b, pneumococcus, Bordetella pertussis antigens, tetanus toxoid and hepatitis B surface antigen. The study was conducted from March 2009 to April 2010 and included 47 women who had HIV and 62 women without HIV. The researchers collected serum samples from 104 women and 100 infants at birth and samples from 93 infants 16 weeks later.
Forty-six of the babies who were considered to be exposed to HIV yet uninfected had significantly lower specific antibody levels compared with unexposed infants (n=54) to Hib, pertussis, pneumococcus and tetanus. The infants who had been exposed to HIV but were not infected also had robust antibody responses after vaccination compared with infants who had not been exposed to HIV.
The 46 mothers who had HIV seemed to have lower specific antibody levels than the 58 uninfected women to Hib and pneumococcus, with no differences observed for pertussis or tetanus.
The researchers said the results of their study support the evaluation of new maternal and neonatal immunization strategies to augment specific antibody responses and potentially prevent infections in infants in early life, particularly in infants who are exposed to HIV.
“The high prevalence of maternal HIV in many parts of the resource-poor world, coupled with successful programs to reduce mother-to-child transmission of HIV, has led to increasing numbers of HIV-exposed infants who are not HIV-infected themselves. These infants and children represent a vulnerable group with increased rates of lower respiratory tract infection and meningitis and up to fourfold higher mortality in the first year of life,” the researchers concluded. “Altered immune responses might contribute to the high morbidity and mortality observed in HIV-exposed uninfected infants.”
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