Abstract
BackgroundHIV-exposed uninfected infants have increased infection risk and mortality compared to HIV-unexposed infants. HIV-exposed infants may be at increased risk of invasive GBS disease due to reduced maternal antibody against GBS. MethodsWe quantified antibodies that bind to the surface of whole Group B Streptococcus (GBS) of serotypes Ia, Ib, II, III and V using novel flow cytometry assays in South African HIV-infected and non-infected mothers and their uninfected infants. Antibody-mediated complement C3b/iC3b deposition onto GBS of these serotypes was also quantified by a novel flow cytometry assay. ResultsGeometric mean concentration (GMC) of both surface-binding anti-GBS antibody and antibody-mediated complement deposition onto GBS were reduced in HIV-infected women (n=46) compared to HIV-uninfected women (n=58) for ST1a (surface-binding: 19.3 vs 29.3; p=0.003; complement deposition: 2.9 vs 5.3SU/mL; p=0.003), STIb (24.9 vs 47.6; p=0.003; 2.6 vs 4.9SU/mL; p=0.003), STII (19.8 vs 50.0; p=0.001; 3.1 vs 6.2SU/mL; p=0.001), STIII (27.8 vs 60.1; p=0.001; 2.8 vs 5.3SU/mL; p=0.001) and STV (121.9 vs 185.6SU/mL; p<0.001) and in their infants for STIa (complement deposition 9.4 vs 27.0SU/mL; p=0.02), STIb (13.4 vs 24.5SU/mL; p=0.02), STII (14.6 vs 42.7SU/mL; p=0.03), STIII (26.6 vs 62.7SU/mL; p=0.03) and STV (90.4 vs 165.8SU/mL; p=0.04). Median transplacental transfer of antibody from HIV-infected women to their infants was reduced compared to HIV-uninfected women for GBS serotypes II (0.42 [IQR 0.22–0.59] vs 1.0SU/mL [0.42–1.66]; p<0.001), III (0.54 [0.31–1.03] vs 0.95SU/mL [0.42–3.05], p=0.05) and V (0.51 [0.28–0.79] vs 0.75SU/mL [0.26–2.9], p=0.04). The differences between infants remained significant at 16 weeks of age. ConclusionsMaternal HIV infection was associated with lower anti-GBS surface binding antibody concentration and antibody-mediated C3b/iC3b deposition onto GBS bacteria of serotypes Ia, Ib, II, III and V. This may render these infants more susceptible to early and late onset GBS disease.
Highlights
The increasing numbers of HIV-exposed infants who remain uninfected is testament to the success of prevention of mother-tochild transmission programs in resource-poor settings in the faceଝ Preliminary data was presented at the European Society of Infectious Diseases meeting May 2014, Dublin, Ireland.of a high disease burden [1]
Our findings demonstrate that total surface binding and functional maternal antibody concentration to each of the Group B Streptococcus (GBS) serotypes (Ia, Ib, II, III and V) is lower at delivery in HIV-infected women compared to their HIV-uninfected peers
It follows that infants born to HIV-infected women had lower anti-GBS surface binding antibody concentrations at birth for all serotypes; this difference was still evident at 16 weeks of age
Summary
The increasing numbers of HIV-exposed infants who remain uninfected is testament to the success of prevention of mother-tochild transmission programs in resource-poor settings in the faceଝ Preliminary data was presented at the European Society of Infectious Diseases meeting May 2014, Dublin, Ireland.of a high disease burden [1]. Methods: We quantified antibodies that bind to the surface of whole Group B Streptococcus (GBS) of serotypes Ia, Ib, II, III and V using novel flow cytometry assays in South African HIV-infected and noninfected mothers and their uninfected infants. Conclusions: Maternal HIV infection was associated with lower anti-GBS surface binding antibody concentration and antibody-mediated C3b/iC3b deposition onto GBS bacteria of serotypes Ia, Ib, II, III and V. This may render these infants more susceptible to early and late onset GBS disease
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