Cord Blood RSV-Neutralizing Antibodies and Risk of Hospitalization for RSV-Associated Acute Respiratory Infection in Vietnamese Children: A Case-Cohort Study.

IF 5.2 3区医学 Q1 IMMUNOLOGY

Vaccines Pub Date : 2025-09-11 DOI:10.3390/vaccines13090963

Michiko Toizumi, Yutaro Yamagata, Hien Anh Thi Nguyen, Hirono Otomaru, Hoang Huy Le, Hiroyuki Moriuchi, Jean-Francois Eleouet, Marie-Anne Rameix-Welti, Makoto Takeda, Hung Thai Do, Lay-Myint Yoshida

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Abstract

Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in children, particularly severe during infancy. Maternal RSV-specific neutralizing antibodies (nAbs), transferred via the placenta, may provide protection in early infancy, but the extent and duration of protection remain uncertain.

Objective: We investigated the association between cord blood RSV-A nAb levels and the risk of hospitalization due to RSV-associated acute respiratory infection (RSV-ARI) by 24 months of age.

Methods: We conducted a case-cohort study nested within a birth cohort in Nha Trang, Vietnam. From the full cohort (n = 1977), a random subcohort of 392 infants and all 66 infants hospitalized for RSV-ARI by age 24 months were included for RSV-A nAb testing. RSV-A nAb titers at birth were categorized into three groups in the subcohort (low: lowest quartile; middle; interquartile; high: highest quartile). Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) for RSV-ARI hospitalization.

Results: The incidence of RSV-ARI hospitalization was 17.92 per 1000 person-years by 24 months, and 25.40 per 1000 person-years among infants aged <12 months. Among infants aged <6 months, those in the low nAb group had a significantly higher risk of hospitalization compared to the middle nAb group (adjusted HR: 4.05; 95% CI: 1.51-10.89). Maternal anemia was consistently associated with increased risk.

Conclusions: Lower RSV-nAb titers at birth were associated with an increased risk of RSV-ARI hospitalization during early infancy. These findings support the importance of maternal immunization strategies to enhance infant protection against RSV.

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越南儿童脐带血rsv中和抗体和rsv相关急性呼吸道感染住院风险：一项病例队列研究

背景：呼吸道合胞病毒（RSV）是儿童下呼吸道感染的主要原因，在婴儿期尤为严重。通过胎盘转移的母体rsv特异性中和抗体（nab）可能在婴儿期早期提供保护，但保护的程度和持续时间仍不确定。目的：探讨脐带血RSV-A nAb水平与24月龄时因rsv相关急性呼吸道感染（RSV-ARI）住院风险的关系。方法：我们在越南芽庄的一个出生队列中进行了一项病例队列研究。从整个队列（n = 1977）中，随机纳入392名婴儿和所有66名24月龄因RSV-ARI住院的婴儿进行RSV-A nAb检测。出生时RSV-A nAb滴度在亚队列中分为三组（低：最低四分位数；中；四分位数间；高：最高四分位数）。加权Cox比例风险回归用于估计RSV-ARI住院的风险比（hr）。结果：出生时较低的RSV-nAb滴度与婴儿期早期RSV-ARI住院风险增加相关。这些发现支持了孕产妇免疫策略对增强婴儿对呼吸道合胞病毒的保护的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccines Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

8.90

自引率

16.70%

发文量

1853

审稿时长

18.06 days

期刊介绍： Vaccines (ISSN 2076-393X) is an international, peer-reviewed open access journal focused on laboratory and clinical vaccine research, utilization and immunization. Vaccines publishes high quality reviews, regular research papers, communications and case reports.