title: Reduction of antimalarial antibodies by HIV infection is associated with increased risk of Plasmodium falciparum cord blood infection.
abstract: BACKGROUND
  Plasmodium falciparum infection in pregnancy can lead to congenital malaria, which has detrimental health consequences for infants. Human immunodeficiency virus (HIV) might increase cord blood P. falciparum infection by decreasing maternal antimalarial-specific antibodies.
  
  
  METHODS
  HIV-negative (n=133) and HIV-positive (n=55) Mozambican pregnant women were assessed at delivery for maternal and cord P. falciparum infection by quantitative polymerase chain reaction (qPCR) and P. falciparum-specific antibodies by enzyme-linked immunosorbent assay and flow cytometry.
  
  
  RESULTS
  Prevalence of qPCR-detected cord blood infection was 8.0%. Risk of cord infection was increased in presence of HIV (adjusted odds ratio [AOR], 3.80; P=.04) and placental malaria (AOR, 22.08; P=.002) after adjusting for clinical variables. The odds of having a high immunoglobulin G response to chondrotin sulphate A-binding infected erythrocytes, parasite lysate, and erythrocyte-binding antigen-175 were reduced among HIV-positive women (P < .001, .048, and .056, respectively) and among women with cord P. falciparum infection (P = .009, .04, and .046, respectively). In multivariate analysis including maternal HIV status, placental malaria, and antibody responses, HIV was no longer associated with cord blood infection (P = .11).
  
  
  CONCLUSIONS
  HIV-associated impairment of antibody responses in pregnant women may contribute to a higher transmission of P. falciparum to their infants.
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Spain.
authors.forename: Denise
authors.initials: D
authors.lastname: Naniche
authors.forename: Elisa
authors.initials: E
authors.lastname: Serra-Casas
authors.forename: Azucena
authors.initials: A
authors.lastname: Bardají
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quintó
authors.forename: Carlota
authors.initials: C
authors.lastname: Dobaño
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigauque
authors.forename: Pau
authors.initials: P
authors.lastname: Cisteró
authors.forename: Virander S
authors.initials: VS
authors.lastname: Chauhan
authors.forename: Chetan E
authors.initials: CE
authors.lastname: Chitnis
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menéndez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mayor
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D016054:DNA, Protozoan / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000469:parasitology; D005434:Flow Cytometry; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000276:immunology* / Q000635:transmission; D009073:Mozambique / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan