Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants
| Autor: | Marisa Márcia Mussi-Pinhata, Jorge Pinto, George K. Siberry, Jennifer S. Read, Rachel A. Cohen, Volia de Carvalho Almeida, Laura Freimanis, Maria Lourdes B. Teixeira, Fabiana Rezende Amaral, Qilu Yu, Regina Célia de Menezes Succi, Adriana Weinberg |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male RECÉM-NASCIDO Immunology Antibodies Viral Virus Serology Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics Humans Immunology and Allergy Medicine Prospective Studies 030212 general & internal medicine Respiratory Tract Infections biology business.industry Incidence (epidemiology) Infant Newborn Infant virus diseases Transplacental Environmental Exposure Environmental exposure medicine.disease Infectious Diseases Virus Diseases Tetanus vaccine Antibody Formation biology.protein Female Antibody business medicine.drug |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/qad.0000000000001393 |
| Popis: | Objective HIV-exposed uninfected (HEUs) infants have frequent severe infection, hospitalization, and death. We performed a serologic investigation to determine the role of common childhood respiratory pathogens in the excess incidence of infections in HEUs. Design Prospective cohort study of mother-infant pairs. Methods Among 247 HEUs and 88 HIV-unexposed uninfected (HUU) infant-mother pairs, we measured maternal antibodies to respiratory syncytial virus (RSV) and pneumococcus (PNC 1, 5, 6B, 14); infant antibodies to RSV, influenza A (flu), parainfluenza viruses (1, 2, 3), and PNC 1, 5, 6B, and 14 were measured at 0 and 6 months, and antitetanus antibodies at 6 months. Results HIV-infected mothers had higher RSV and lower PNC antibody concentrations at delivery than uninfected mothers. Transplacental transfer of maternal antibodies, particularly for RSV, was lower in HEUs compared with HUUs. At birth, HEUs had higher concentrations of anti-RSV antibodies than HUUs, but lower antibodies to the other respiratory agents. At 6 months, HEUs had significantly higher proportions of seroconversions and higher antibody concentrations against parainfluenza viruses 1, 2, and 3. There were no significant differences in seroconversions to flu and RSV, but antibody concentrations to RSV were six-fold lower in HEUs versus HUUs at 6 months. Antibody responses to at least two doses of tetanus vaccine were also six-fold lower in HEUs compared with HUUs. Conclusion Six-month-old HEUs had a higher incidence of respiratory viral infections than HUUs. In addition to the low passive protection from maternal antibodies, low antibody responses of HEUs may contribute to increased morbidity and mortality. |
| Databáze: | OpenAIRE |
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