Abstract
BackgroundMaternal antibodies are key components of the protective responses of infants who are unable to produce their own IgG until 6 months of life. There is evidence that HIV-exposed uninfected children (HEU) have IgG levels abnormalities, that can be partially responsible for the higher vulnerability to infections in the first 2 years of the life of this population.This retrospective study aimed to characterize the dynamics in plasma levels of total IgG and their isotypes during the first 2 years of life in HEU infants exclusively breastfed through 6 months of age.MethodsTotal IgG, IgG1, IgG2, IgG3 and IgG4 isotypes, and IgM and IgA plasma concentrations were determined by nephelometric methods in 30 Malawian infants born to HIV-positive women at month 1, 6 and 24 of life.ResultsAt 1-month infants had a median concentration of total IgG of 8.48 g/l, (IQR 7.57–9.15), with an overrepresentation of the IgG1 isotype (89.0% of total) and low levels of IgG2 (0.52 g/l, IQR, 0.46–0.65). Total IgG and IgG1 concentrations were lower at 6 months (− 2.1 and − 1.12 g/dl, respectively) reflecting disappearance of maternal antibodies, but at 24 months their levels were higher with respect to the reported reference values for age-matched pairs. Abnormal isotype distribution was still present at 24 months with IgG2 remaining strongly underrepresented (0.87 g/l, 7.5% of total IgG).ConclusionHIV exposure during pregnancy and breastfeeding seems to influence the IgG maturation and isotype distribution that persist in 2-year old infants.
Highlights
Maternal antibodies are key components of the protective responses of infants who are unable to produce their own IgG until 6 months of life
The process of immunoglobulins development and maturation starts during intrauterine life [1] the fetus can not produce IgGs, that are received from the mother in a complex mechanism of selective placental passage
Our group reported that the IgG2 deficit in HIV-exposed uninfected children (HEU) infants could be attributable to the low levels of circulating IgG2 in Human immunodeficiency virus (HIV)-positive pregnant women, suggesting that the low affinity with FcRn receptors of placenta together with maternal low levels could synergically contribute to the IgG2 deficit in neonates [32]
Summary
Maternal antibodies are key components of the protective responses of infants who are unable to produce their own IgG until 6 months of life. There is evidence that HIV-exposed uninfected children (HEU) have IgG levels abnormalities, that can be partially responsible for the higher vulnerability to infections in the first 2 years of the life of this population. This retrospective study aimed to characterize the dynamics in plasma levels of total IgG and their isotypes during the first 2 years of life in HEU infants exclusively breastfed through 6 months of age. HIV studies on antenatal vaccine programs have reported impaired passage through the placenta [14,15,16]
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