Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants

Adriana Weinberg, Marisa M. Mussi-Pinhata, Qilu Yu, Rachel A. Cohen, Volia C. Almeida, Fabiana Amaral, Jorge Pinto, Maria L B Teixeira, Regina C M Succi, Laura Freimanis, Jennifer S. Read, George Siberry, for the NISDI Perinatal, LILAC, CIRAI Protocols

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:: HIV-exposed uninfected infants (HEUs) have frequent severe infection, hospitalization and death. We performed a serologic investigation to determine the role of common childhood respiratory pathogens in the excess incidence of infections in HEUs. DESIGN:: Prospective cohort study of mother-infant pairs. METHODS:: Among 247 HEUs and 88 HIV-unexposed uninfected (HUU) infant-mother pairs, we measured maternal antibodies to respiratory syncytial virus (RSV) and pneumococcus (PNC 1, 5, 6B, 14); infant antibodies to RSV, influenza A (Flu), parainfluenza viruses (PIV 1, 2, 3), and PNC 1, 5, 6B and 14 were measured at 0 and 6 months, and anti-tetanus antibodies at 6 months. RESULTS:: HIV-infected mothers had higher RSV and lower PNC antibody concentrations at delivery than uninfected mothers. Transplacental transfer of maternal antibodies, particularly for RSV, was lower in HEUs compared to HUUs. At birth, HEUs had higher concentrations of anti-RSV antibodies than HUUs, but lower antibodies to the other respiratory agents. At 6 months, HEUs had significantly higher proportions of seroconversions and higher antibody concentrations against PIV 1, 2 and 3. There were no significant differences in seroconversions to Flu and RSV, but antibody concentrations to RSV were 6-fold lower in HEUs versus HUUs at 6 months. Antibody responses to ≥2 doses of tetanus vaccine were also 6-fold lower in HEUs compared with HUUs. CONCLUSION:: Six-month old HEUs had a higher incidence of respiratory viral infections than HUUs. In addition to the low passive protection from maternal antibodies, low antibody responses of HEUs may contribute to increased morbidity and mortality.

Original languageEnglish (US)
JournalAIDS
DOIs
StateAccepted/In press - Jan 4 2017
Externally publishedYes

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Virus Diseases
Respiratory Tract Infections
Respiratory Syncytial Viruses
Antibody Formation
HIV
Antibodies
Mothers
Paramyxoviridae Infections
Tetanus Toxoid
Incidence
Tetanus
Streptococcus pneumoniae
Infection
Human Influenza
Anti-Idiotypic Antibodies
Hospitalization
Cohort Studies
Parturition
Prospective Studies
Viruses

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Weinberg, A., Mussi-Pinhata, M. M., Yu, Q., Cohen, R. A., Almeida, V. C., Amaral, F., ... for the NISDI Perinatal, LILAC, CIRAI Protocols (Accepted/In press). Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants. AIDS. https://doi.org/10.1097/QAD.0000000000001393

Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants. / Weinberg, Adriana; Mussi-Pinhata, Marisa M.; Yu, Qilu; Cohen, Rachel A.; Almeida, Volia C.; Amaral, Fabiana; Pinto, Jorge; Teixeira, Maria L B; Succi, Regina C M; Freimanis, Laura; Read, Jennifer S.; Siberry, George; for the NISDI Perinatal, LILAC, CIRAI Protocols.

In: AIDS, 04.01.2017.

Research output: Contribution to journalArticle

Weinberg, A, Mussi-Pinhata, MM, Yu, Q, Cohen, RA, Almeida, VC, Amaral, F, Pinto, J, Teixeira, MLB, Succi, RCM, Freimanis, L, Read, JS, Siberry, G & for the NISDI Perinatal, LILAC, CIRAI Protocols 2017, 'Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants', AIDS. https://doi.org/10.1097/QAD.0000000000001393
Weinberg, Adriana ; Mussi-Pinhata, Marisa M. ; Yu, Qilu ; Cohen, Rachel A. ; Almeida, Volia C. ; Amaral, Fabiana ; Pinto, Jorge ; Teixeira, Maria L B ; Succi, Regina C M ; Freimanis, Laura ; Read, Jennifer S. ; Siberry, George ; for the NISDI Perinatal, LILAC, CIRAI Protocols. / Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants. In: AIDS. 2017.
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abstract = "OBJECTIVE:: HIV-exposed uninfected infants (HEUs) have frequent severe infection, hospitalization and death. We performed a serologic investigation to determine the role of common childhood respiratory pathogens in the excess incidence of infections in HEUs. DESIGN:: Prospective cohort study of mother-infant pairs. METHODS:: Among 247 HEUs and 88 HIV-unexposed uninfected (HUU) infant-mother pairs, we measured maternal antibodies to respiratory syncytial virus (RSV) and pneumococcus (PNC 1, 5, 6B, 14); infant antibodies to RSV, influenza A (Flu), parainfluenza viruses (PIV 1, 2, 3), and PNC 1, 5, 6B and 14 were measured at 0 and 6 months, and anti-tetanus antibodies at 6 months. RESULTS:: HIV-infected mothers had higher RSV and lower PNC antibody concentrations at delivery than uninfected mothers. Transplacental transfer of maternal antibodies, particularly for RSV, was lower in HEUs compared to HUUs. At birth, HEUs had higher concentrations of anti-RSV antibodies than HUUs, but lower antibodies to the other respiratory agents. At 6 months, HEUs had significantly higher proportions of seroconversions and higher antibody concentrations against PIV 1, 2 and 3. There were no significant differences in seroconversions to Flu and RSV, but antibody concentrations to RSV were 6-fold lower in HEUs versus HUUs at 6 months. Antibody responses to ≥2 doses of tetanus vaccine were also 6-fold lower in HEUs compared with HUUs. CONCLUSION:: Six-month old HEUs had a higher incidence of respiratory viral infections than HUUs. In addition to the low passive protection from maternal antibodies, low antibody responses of HEUs may contribute to increased morbidity and mortality.",
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T1 - Excess respiratory viral infections and low antibody responses among HIV-exposed, uninfected infants

AU - Weinberg, Adriana

AU - Mussi-Pinhata, Marisa M.

AU - Yu, Qilu

AU - Cohen, Rachel A.

AU - Almeida, Volia C.

AU - Amaral, Fabiana

AU - Pinto, Jorge

AU - Teixeira, Maria L B

AU - Succi, Regina C M

AU - Freimanis, Laura

AU - Read, Jennifer S.

AU - Siberry, George

AU - for the NISDI Perinatal, LILAC, CIRAI Protocols

PY - 2017/1/4

Y1 - 2017/1/4

N2 - OBJECTIVE:: HIV-exposed uninfected infants (HEUs) have frequent severe infection, hospitalization and death. We performed a serologic investigation to determine the role of common childhood respiratory pathogens in the excess incidence of infections in HEUs. DESIGN:: Prospective cohort study of mother-infant pairs. METHODS:: Among 247 HEUs and 88 HIV-unexposed uninfected (HUU) infant-mother pairs, we measured maternal antibodies to respiratory syncytial virus (RSV) and pneumococcus (PNC 1, 5, 6B, 14); infant antibodies to RSV, influenza A (Flu), parainfluenza viruses (PIV 1, 2, 3), and PNC 1, 5, 6B and 14 were measured at 0 and 6 months, and anti-tetanus antibodies at 6 months. RESULTS:: HIV-infected mothers had higher RSV and lower PNC antibody concentrations at delivery than uninfected mothers. Transplacental transfer of maternal antibodies, particularly for RSV, was lower in HEUs compared to HUUs. At birth, HEUs had higher concentrations of anti-RSV antibodies than HUUs, but lower antibodies to the other respiratory agents. At 6 months, HEUs had significantly higher proportions of seroconversions and higher antibody concentrations against PIV 1, 2 and 3. There were no significant differences in seroconversions to Flu and RSV, but antibody concentrations to RSV were 6-fold lower in HEUs versus HUUs at 6 months. Antibody responses to ≥2 doses of tetanus vaccine were also 6-fold lower in HEUs compared with HUUs. CONCLUSION:: Six-month old HEUs had a higher incidence of respiratory viral infections than HUUs. In addition to the low passive protection from maternal antibodies, low antibody responses of HEUs may contribute to increased morbidity and mortality.

AB - OBJECTIVE:: HIV-exposed uninfected infants (HEUs) have frequent severe infection, hospitalization and death. We performed a serologic investigation to determine the role of common childhood respiratory pathogens in the excess incidence of infections in HEUs. DESIGN:: Prospective cohort study of mother-infant pairs. METHODS:: Among 247 HEUs and 88 HIV-unexposed uninfected (HUU) infant-mother pairs, we measured maternal antibodies to respiratory syncytial virus (RSV) and pneumococcus (PNC 1, 5, 6B, 14); infant antibodies to RSV, influenza A (Flu), parainfluenza viruses (PIV 1, 2, 3), and PNC 1, 5, 6B and 14 were measured at 0 and 6 months, and anti-tetanus antibodies at 6 months. RESULTS:: HIV-infected mothers had higher RSV and lower PNC antibody concentrations at delivery than uninfected mothers. Transplacental transfer of maternal antibodies, particularly for RSV, was lower in HEUs compared to HUUs. At birth, HEUs had higher concentrations of anti-RSV antibodies than HUUs, but lower antibodies to the other respiratory agents. At 6 months, HEUs had significantly higher proportions of seroconversions and higher antibody concentrations against PIV 1, 2 and 3. There were no significant differences in seroconversions to Flu and RSV, but antibody concentrations to RSV were 6-fold lower in HEUs versus HUUs at 6 months. Antibody responses to ≥2 doses of tetanus vaccine were also 6-fold lower in HEUs compared with HUUs. CONCLUSION:: Six-month old HEUs had a higher incidence of respiratory viral infections than HUUs. In addition to the low passive protection from maternal antibodies, low antibody responses of HEUs may contribute to increased morbidity and mortality.

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