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

Ho, Antonio, Mapurisa, Gugulethu, Madanitsa, Mwayiwawo, Kalilani-Phiri, Linda, Kamiza, Steve Kamiza, Makanani, B, Ter Kuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Buys, Amelia, Treurnicht, Florette, Everett, Dean, Mwapasa, Victor, Widdowson, Marc-Alain, McMorrow, Meredith and Heyderman, Robert S. (2019) '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, Vol 6, Issue 10, ofz383.

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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=0.02; infants 24.3 vs. 50.5%, p=0.003) and A(H3N2) (mothers, 37.8% vs. 63.9%, p=0.003; infants 43.2 vs. 64.8%, p=0.01), whereas placental malaria had inconsistent effect on maternal and infant seropositivity. In multivariable analyses, maternal HIV infection was associated with reduced infant seropositivity (A(H1N1)pdm09 aOR 0.34, 95%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.
Discussion. Maternal HIV infection influenced maternal antibody response to influenza A virus infection and therefore antibody levels in newborns, but did not affect transplacental antibody transfer.

Item Type:	Article
Subjects:	QW Microbiology and Immunology > Antigens and Antibodies. Toxins and Antitoxins > QW 575 Antibodies WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.3 Etiology. Transmission WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 515 Human influenza WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/ofid/ofz383
Depositing User:	Helen Wong
Date Deposited:	03 Sep 2019 15:18
Last Modified:	12 Nov 2019 09:30
URI:	https://archive.lstmed.ac.uk/id/eprint/11972

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