Low levels of pertussis- and measles-specific IgG antibodies in 6-week-old HIV-exposed and -unexposed Malawian infants: implications for vaccination strategies and role of long term HIV therapy.

IF 1.8 4区 医学 Q2 PEDIATRICS
Silvia Baroncelli, Clementina Maria Galluzzo, Stefano Orlando, Richard Luhanga, Robert Mphwere, Thom Kavalo, Roberta Amici, Marco Floridia, Mauro Andreotti, Fausto Ciccacci, Maria Cristina Marazzi, Marina Giuliano
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引用次数: 0

Abstract

Serological studies in infants can provide valuable information on the degree of protection conferred by IgG maternal passive transfer during early life. If infant levels are inadequate, protection may be incomplete, increasing the risk of life-threatening diseases such as pertussis and measles, before immunization completion. In addition, HIV infection, -highly prevalent in African countries like Malawi-may impair transplacental antibody transfer. We determined anti-Pertussis Toxin (PT) and anti-measles IgG in 86 6-week-old infants, born to mothers living with HIV (HIV-exposed uninfected, HEU, n = 58) and to HIV-negative mothers (HIV-unexposed uninfected, HUU, n = 28). The HEU group was divided into two subgroups: Infants born to mothers who initiated antiretroviral therapy (ART) during pregnancy (Short-ART, SA-HEU group, n = 29) or already in stable ART (Long-term ART, LA-HEU group, n = 29). The mean anti-PT and anti-measles IgG levels (1.97 IU/ml and 32.9 mIU/ml, respectively) were comparable between the HUU and HEU infants. Overall, only 12.8% and 18.6% of all infants had IgG levels above the protective thresholds for pertussis and measles, respectively. The duration of ART significantly influenced the infant's serological profile, with SA-HEU infants showing significantly lower IgG levels compared to both HUU and LA-HEU infants. Protecting infants during early life remains a significant health challenge in many middle and low-income countries. Achieving better early serological protection requires the implementation of diverse vaccination strategies. This study emphasizes the crucial importance for women living with HIV to be on stable ART before pregnancy.

6周大的艾滋病毒暴露和未暴露的马拉维婴儿百日咳和麻疹特异性IgG抗体水平低:对疫苗接种策略和长期艾滋病毒治疗作用的影响
婴儿的血清学研究可以提供有价值的信息,了解IgG母体在生命早期被动转移所赋予的保护程度。如果婴儿免疫水平不足,则保护可能不完全,从而增加了在完成免疫接种之前罹患百日咳和麻疹等危及生命疾病的风险。此外,艾滋病毒感染——在马拉维等非洲国家高度流行——可能会损害经胎盘抗体转移。我们检测了86名6周龄婴儿的抗百日咳毒素(PT)和抗麻疹IgG,这些婴儿的母亲感染艾滋病毒(HIV暴露未感染,HEU, n = 58)和HIV阴性母亲(HIV暴露未感染,HUU, n = 28)。HEU组分为两个亚组:母亲在怀孕期间开始抗逆转录病毒治疗(ART)的婴儿(Short-ART, SA-HEU组,n = 29)或已经接受稳定ART治疗的婴儿(长期ART, LA-HEU组,n = 29)。HUU和HEU婴儿的平均抗pt和抗麻疹IgG水平(分别为1.97 IU/ml和32.9 mIU/ml)具有可比性。总体而言,只有12.8%和18.6%的婴儿IgG水平分别高于百日咳和麻疹的保护阈值。抗逆转录病毒治疗的持续时间显著影响婴儿的血清学特征,与HUU和LA-HEU婴儿相比,SA-HEU婴儿的IgG水平明显较低。在许多中低收入国家,在生命早期保护婴儿仍然是一项重大的健康挑战。实现更好的早期血清学保护需要实施多种疫苗接种战略。这项研究强调了感染艾滋病毒的妇女在怀孕前接受稳定的抗逆转录病毒治疗的重要性。
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来源期刊
Journal of Tropical Pediatrics
Journal of Tropical Pediatrics 医学-热带医学
CiteScore
4.00
自引率
0.00%
发文量
97
审稿时长
6-12 weeks
期刊介绍: The Journal of Tropical Pediatrics provides a link between theory and practice in the field. Papers report key results of clinical and community research, and considerations of programme development. More general descriptive pieces are included when they have application to work preceeding elsewhere. The journal also presents review articles, book reviews and, occasionally, short monographs and selections of important papers delivered at relevant conferences.
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