Impact of maternal HIV infection and placental malaria on the transplacental transfer of influenza antibodies in mother-infant pairs in Malawi

Ho, A. et al. (2019) Impact of maternal HIV infection and placental malaria on the transplacental transfer of influenza antibodies in mother-infant pairs in Malawi. Open Forum Infectious Diseases, 6(10), ofz383. (doi: 10.1093/ofid/ofz383) (PMID:31660347) (PMCID:PMC6785697)

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.

• Item Type: Articles
• Additional Information: Financial support. This study was supported by the Centers for Disease Control and Prevention (Cooperative Agreement 5U01IP000848) and the Malawi Liverpool Wellcome Trust Programme Core Award (101113/Z/13/Z).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ho, Dr Antonia
• Authors: Ho, A., Mapurisa, G., Madanitsa, M., Kalilani-Phiri, L., Kamiza, S., Makanani, B., Ter Kuile, F. O., Buys, A., Treurnicht, F., Everett, D., Mwapasa, V., Widdowson, M.-A., McMorrow, M., and Heyderman, R. S.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
• Journal Name: Open Forum Infectious Diseases
• Publisher: Oxford University Press
• ISSN: 2328-8957
• ISSN (Online): 2328-8957
• Published Online: 28 August 2019