Synergy between mannose-binding lectin gene polymorphisms and supplementation with vitamin A influences susceptibility to HIV infection in infants born to HIV-positive mothers.
BACKGROUND
Mannose-binding lectin (MBL-2) allele variants are associated with deficiencies in innate immunity and have been found to be correlated with HIV infection in adults and children.


OBJECTIVE
We tested whether MBL-2 variants among infants born to HIV-positive mothers have an increased susceptibility to HIV.


METHODS
MBL-2 allele variants were measured among 225 infants born to HIV-positive mothers enrolled in a trial in Durban, South Africa. Mothers of 108 infants were randomly assigned to receive vitamin A and beta-carotene supplementation and 117 to receive placebo. Infants were followed with regular HIV tests to determine rates of mother-to-child HIV transmission.


RESULTS
A high proportion of infants were either homozygous (10.7%) or heterozygous (32.4%) for MBL-2 variants. MBL-2 variants within the placebo arm were associated with an increased risk of HIV transmission (odds ratio: 3.09; 95% CI: 1.21, 7.86); however, MBL-2 variants within the supplementation arm were not associated with an increased risk of transmission (P = 0.04; test of interaction). Among infants with MBL-2 variants, supplementation was associated with a decreased risk of HIV transmission (odds ratio: 0.37; 95% CI: 0.15, 0.91).


CONCLUSIONS
We observed what appears to be a gene-environment interaction between MBL-2 variants and an intervention with vitamin A plus beta-carotene that is relevant to mother-to-child HIV transmission.
Kuhn
Louise
L
Gertrude H Sergievsky Center, College of Physicians and Surgeons, and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. lk24@columbia.edu
Coutsoudis
Anna
A
Trabattoni
Daria
D
Archary
Derseree
D
Rossi
Tatiana
T
Segat
Ludovica
L
Clerici
Mario
M
Crovella
Sergio
S
D000328:Adult; D000483:Alleles; D016001:Confidence Intervals; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007113:Immunity, Innate; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D037601:Mannose-Binding Lectin / Q000235:genetics*; D016017:Odds Ratio; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D011256:Pregnancy Outcome; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use*; D019207:beta Carotene / Q000097:blood / Q000627:therapeutic use
D037601:Mannose-Binding Lectin; D019207:beta Carotene; D014801:Vitamin A