title: Maternal Antibody Responses and Nonprimary Congenital Cytomegalovirus Infection of HIV-1-Exposed Infants.
abstract: Risk of congenital cytomegalovirus (cCMV) transmission is highly dependent on the presence of preexisting maternal immunity, with the lowest rates observed in CMV-seroimmune populations. Among infants of CMV-seroimmune women, those who are exposed to human immunodeficiency virus (HIV) have an increased risk of acquiring cCMV infection as compared to HIV-unexposed infants. To better understand the risk factors of nonprimary cCMV transmission in HIV-infected women, we performed a case-control study in which CMV-specific plasma antibody responses from 19 CMV-transmitting and 57 CMV-nontransmitting women with chronic CMV/HIV coinfection were evaluated for the ability to predict the risk of cCMV infection. Primary multivariable conditional logistic regression analysis revealed an association between epithelial-tropic CMV neutralizing titers and a reduced risk of cCMV transmission (odds ratio [OR], 0.18; 95% confidence interval [CI], .03-.93; P = .04), although this effect was not significant following correction for multiple comparisons (false-discovery rate, 0.12). Exploratory analysis of the CMV specificity of plasma antibodies revealed that immunoglobulin G (IgG) responses against the glycoprotein B (gB) neutralizing epitope AD-2 had a borderline association with low risk of transmission (OR, 0.72; 95% CI, .51-1.00; P = .05), although this was not confirmed in a post hoc plasma anti-AD-2 IgG blocking assay. Our data suggest that maternal neutralizing antibody responses may play a role in protection against cCMV in HIV/CMV-coinfected populations.
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham.
authors.forename: Kristy M
authors.initials: KM
authors.lastname: Bialas
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Westreich
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cisneros de la Rosa
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham.
authors.forename: Cody S
authors.initials: CS
authors.lastname: Nelson
authors.affiliation: Trellis Bioscience, Menlo Park, California.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Kauvar
authors.affiliation: Merck, Kenilworth, New Jersey.
authors.forename: Tong-Ming
authors.initials: TM
authors.lastname: Fu
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham.
authors.forename: Sallie R
authors.initials: SR
authors.lastname: Permar
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000917:Antibody Formation; D016022:Case-Control Studies; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
keywords: HIV-exposed infants; maternal antibodies; nonprimary congenital cytomegalovirus