title: Neonatal measles immunity in rural Kenya: the influence of HIV and placental malaria infections on placental transfer of antibodies and levels of antibody in maternal and cord serum samples.
abstract: BACKGROUND
  Young infants are protected from measles infection by maternal measles antibodies. The level of these antibodies at birth depends on the level of antibodies in the mother and the extent of placental transfer. We investigated predictors of levels of measles antibodies in newborns in rural Kenya.
  
  
  METHODS
  A total of 747 paired maternal-cord serum samples (91 from human immunodeficiency virus [HIV]-infected and 656 from HIV-uninfected mothers) were tested for measles immunoglobulin G antibodies. Placental malaria infection was determined by biopsy. Data on pregnancy history, gestational age, and anthropometric and socioeconomic status were collected.
  
  
  RESULTS
  Infants born to HIV-infected mothers were more likely (odds ratio, 4.6 [95% confidence interval {CI}, 2.2-9.7]) to be seronegative and had 35.1% (95% CI, 9.8%-53.2%) lower levels of measles antibodies than did those born to HIV-uninfected mothers. Preterm delivery, early maternal age, and ethnic group were also associated with reduced levels of measles antibodies. There was little evidence that placental malaria infection was associated with levels of measles antibodies in newborns.
  
  
  CONCLUSIONS
  Our results suggest that maternal HIV infection may reduce levels of measles antibodies in newborns. Low levels of measles antibodies at birth render children susceptible to measles infection at an early age. This is of concern in sub-Saharan African countries, where not only is the prevalence of HIV high, but measles is the cause of much morbidity and mortality.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. Susana.Scott@lshtm.ac.uk
authors.forename: Susana
authors.initials: S
authors.lastname: Scott
authors.forename: Phillippa
authors.initials: P
authors.lastname: Cumberland
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Shulman
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Cohen
authors.forename: David W G
authors.initials: DW
authors.lastname: Brown
authors.forename: Judith N
authors.initials: JN
authors.lastname: Bulmer
authors.forename: Edgar K
authors.initials: EK
authors.lastname: Dorman
authors.forename: Ken
authors.initials: K
authors.lastname: Kawuondo
authors.forename: Kevin
authors.initials: K
authors.lastname: Marsh
authors.forename: Felicity
authors.initials: F
authors.lastname: Cutts
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007231:Infant, Newborn; D007630:Kenya; D008288:Malaria / Q000150:complications*; D008457:Measles / Q000150:complications / Q000276:immunology*; D010920:Placenta / Q000469:parasitology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D012424:Rural Population
chemical_list: D000914:Antibodies, Viral