Maternal pneumococcal capsular IgG antibodies and transplacental transfer are low in South Asian HIV-infected mother-infant pairs.
BACKGROUND
Our understanding of the mother-to-child transfer of serotype-specific pneumococcal antibodies is limited in non-immunized, HIV-positive women.


METHODS
We compared geometric mean antibody concentrations (GMCs), geometric mean transplacental cord:maternal ratios (GMRs) and proportions of samples with protective antibody concentration (≥0.35μg/ml) to serotypes 1, 4, 5, 6B, 9V, 14, 18C, 19F, 23F between 74 HIV-infected and 98 HIV-uninfected mother-infant pairs who had not received pneumococcal immunization in South Asia. Multivariable analysis was performed to assess the influence of HIV on protective antibody concentrations.


RESULTS
HIV-infected mothers and their infants exhibited lower GMCs and GMRs than their uninfected counterparts. This was significant for all serotypes except maternal GMC to serotype 1 and GMR for serotype 6B. In multivariate analysis, HIV was significantly associated with reduced odds of having protective pneumococcal IgG levels; 56-73% reduction for 3 maternal serotypes (4, 5, 23F) and 62-90% reduction for all cord samples except serotype 6B.


CONCLUSIONS
Maternal HIV infection is associated with lower levels of maternal pneumococcal antibodies and disproportionately lower cord antibodies, relative to maternal antibodies, suggesting that HIV infection compromises transplacental transfer. Reassessment of maternal and/or infant pneumococcal immunization strategies is needed in HIV-infected women and their infants.
Johns Hopkins University School of Medicine, Baltimore, MD, United States; Bloomberg School of Public Health, Baltimore, MD, United States; Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India. Electronic address: agupta25@jhmi.edu.
Amita
A
Gupta
Weill Cornell Medical College, New York, NY, United States.
Jyoti S
JS
Mathad
Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Wei-Teng
WT
Yang
Weill Cornell Medical College, New York, NY, United States.
Harjot K
HK
Singh
Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India.
Nikhil
N
Gupte
Johns Hopkins University School of Medicine, Baltimore, MD, United States; Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India.
Vidya
V
Mave
Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India; Byramjee Jeejeebhoy Government Medical College, Sassoon General Hospital, Pune, India.
Renu
R
Bharadwaj
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
K
K
Zaman
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Eliza
E
Roy
Johns Hopkins University School of Medicine, Baltimore, MD, United States; Bloomberg School of Public Health, Baltimore, MD, United States; Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India.
Robert C
RC
Bollinger
Johns Hopkins University, Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit, Pune, India; Byramjee Jeejeebhoy Government Medical College, Sassoon General Hospital, Pune, India.
Ramesh
R
Bhosale
Cincinnati Children's Hospital, Cincinnati, OH, United States.
Mark C
MC
Steinhoff
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D001459:Bangladesh; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D015658:HIV Infections / Q000276:immunology* / Q000382:microbiology; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007074:Immunoglobulin G / Q000097:blood; D007194:India; D007223:Infant; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology; D055815:Young Adult
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G
Antibodies; Bangladesh; Cord; HIV; India; Maternal; Pneumococcus; Serotypes; Transplacental transfer