Sabelle Jallow1, Clare L Cutland2, Alexis K Masbou3, Peter Adrian2, Shabir A Madhi4. 1. Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Centre for Vaccines and Immunology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. Electronic address: sabellejallow@yahoo.com. 2. Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. 3. Stony Brook University School of Medicine, New York USA. 4. Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Centre for Vaccines and Immunology, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Abstract
BACKGROUND: Transplacental transfer of measles antibodies from mother to fetus is important in protecting against measles during early infancy. Changes in population immunity against measles in adults, including waning of immunity among HIV-infected pregnant women, could affect passive immunity acquired in utero by newborns. OBJECTIVES: To evaluate the effect of maternal HIV infection on transplacental transfer of measles antibody in mother-newborn dyads in a setting of high maternal HIV prevalence. STUDY DESIGN: Serum at birth was obtained from 303 mother-newborn dyads, including 196 HIV-infected and 107 HIV-uninfected women, and tested for measles IgG antibodies by ELISA. Seronegativity was defined as antibody levels <150mIU/ml and seroprotective titers as ≥330mIU/ml. RESULTS: HIV-infected and -uninfected women had similar measles antibody titers, however, cord-blood titers were lower among HIV-exposed (788.06mIU/ml) compared to HIV- unexposed newborns (1306.6mIU/ml; p≤0.001), due to lower transplacental antibody transfer ratio in HIV-exposed (0.63) than in HIV-unexposed newborns (0.97; p≤0.001). Maternal age <25years of age was associated with lower antibody titers and lower percentage with seroprotective titer, as well as less likelihood of their newborns having seroprotective titers (70.2% vs. 86.5%; p=0.001). CONCLUSIONS: Lower levels of measles antibody in HIV-exposed newborns and in younger women <25years old, increases the susceptibility of their newborns to developing measles. This suggest a need to re-evaluate measles immunization of women of child bearing age and the timing of measles vaccination among infants in settings with a high prevalence of maternal HIV-infection.
BACKGROUND: Transplacental transfer of measles antibodies from mother to fetus is important in protecting against measles during early infancy. Changes in population immunity against measles in adults, including waning of immunity among HIV-infected pregnant women, could affect passive immunity acquired in utero by newborns. OBJECTIVES: To evaluate the effect of maternal HIV infection on transplacental transfer of measles antibody in mother-newborn dyads in a setting of high maternal HIV prevalence. STUDY DESIGN: Serum at birth was obtained from 303 mother-newborn dyads, including 196 HIV-infected and 107 HIV-uninfectedwomen, and tested for measles IgG antibodies by ELISA. Seronegativity was defined as antibody levels <150mIU/ml and seroprotective titers as ≥330mIU/ml. RESULTS:HIV-infected and -uninfected women had similar measles antibody titers, however, cord-blood titers were lower among HIV-exposed (788.06mIU/ml) compared to HIV- unexposed newborns (1306.6mIU/ml; p≤0.001), due to lower transplacental antibody transfer ratio in HIV-exposed (0.63) than in HIV-unexposed newborns (0.97; p≤0.001). Maternal age <25years of age was associated with lower antibody titers and lower percentage with seroprotective titer, as well as less likelihood of their newborns having seroprotective titers (70.2% vs. 86.5%; p=0.001). CONCLUSIONS: Lower levels of measles antibody in HIV-exposed newborns and in younger women <25years old, increases the susceptibility of their newborns to developing measles. This suggest a need to re-evaluate measles immunization of women of child bearing age and the timing of measles vaccination among infants in settings with a high prevalence of maternal HIV-infection.
Authors: Sepideh Dolatshahi; Audrey L Butler; Mark J Siedner; Joseph Ngonzi; Andrea G Edlow; Julian Adong; Madeleine F Jennewein; Caroline Atyeo; Ingrid V Bassett; Drucilla J Roberts; Douglas A Lauffenburger; Galit Alter; Lisa M Bebell Journal: Clin Infect Dis Date: 2022-10-12 Impact factor: 20.999
Authors: H J Zar; D P Moore; S Andronikou; A C Argent; T Avenant; C Cohen; R J Green; G Itzikowitz; P Jeena; R Masekela; M P Nicol; A Pillay; G Reubenson; S A Madhi Journal: Afr J Thorac Crit Care Med Date: 2020-10-13
Authors: Eleonora A M L Mutsaerts; Marta C Nunes; Martijn N van Rijswijk; Kerstin Klipstein-Grobusch; Diederick E Grobbee; Shabir A Madhi Journal: EClinicalMedicine Date: 2018-07-02