The role of neutralizing antibodies in protection of American Indian infants against respiratory syncytial virus disease

Angelia Eick, Ruth A Karron, Jana Shaw, Bhagvanji Thumar, Raymond Reid, Mathuram Santosham, Katherine L O'Brien

Research output: Contribution to journalArticle

Abstract

Background: Navajo and White Mountain Apache infants have respiratory syncytial virus (RSV) hospitalization rates 2-5 times that of the general U.S. infant population. To evaluate whether these high rates can be attributable to low concentrations of maternally derived RSV neutralizing antibodies, we conducted a case-control study. Methods: Study subjects enrolled in a prospective, hospital-based surveillance study of RSV disease and a group randomized clinical trial of a 7-valent pneumococcal conjugate vaccine. Cord blood specimens were assayed for neutralizing RSV antibody titers. Infants hospitalized with a respiratory illness had a nasal aspirate obtained to determine whether RSV was present. Infants with an RSV respiratory hospitalization were matched by date of birth and geographic location to infants who did not have an RSV hospitalization before 6 months of age. Results: For every 1 log2 increase in titer of cord blood RSV neutralizing antibodies there was a 30% reduced risk of hospitalization with RSV (OR = 0.69, P = 0.003). However, among infants hospitalized with RSV, there was no association between cord blood RSV neutralizing antibody and the severity of the RSV illness. Conclusions: These findings indicate that American Indian infants with high concentrations of maternally derived RSV neutralizing antibodies are protected from RSV hospitalization before 6 months of age. However, these antibodies do not modify the severity of illness once disease has occurred. The basis for elevated rates of RSV disease among American Indian infants cannot be attributed to a failure of maternal RSV neutralizing antibodies to confer protection.

Original languageEnglish (US)
Pages (from-to)207-212
Number of pages6
JournalPediatric Infectious Disease Journal
Volume27
Issue number3
DOIs
StatePublished - Mar 2008

Fingerprint

Respiratory Syncytial Viruses
North American Indians
Virus Diseases
Neutralizing Antibodies
Hospitalization
Fetal Blood
Geographic Locations
Conjugate Vaccines
Pneumococcal Vaccines
Antibodies
Viral Load
Nose

Keywords

  • American Indians
  • Infants
  • Neutralizing antibody
  • Respiratory syncytial virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

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title = "The role of neutralizing antibodies in protection of American Indian infants against respiratory syncytial virus disease",
abstract = "Background: Navajo and White Mountain Apache infants have respiratory syncytial virus (RSV) hospitalization rates 2-5 times that of the general U.S. infant population. To evaluate whether these high rates can be attributable to low concentrations of maternally derived RSV neutralizing antibodies, we conducted a case-control study. Methods: Study subjects enrolled in a prospective, hospital-based surveillance study of RSV disease and a group randomized clinical trial of a 7-valent pneumococcal conjugate vaccine. Cord blood specimens were assayed for neutralizing RSV antibody titers. Infants hospitalized with a respiratory illness had a nasal aspirate obtained to determine whether RSV was present. Infants with an RSV respiratory hospitalization were matched by date of birth and geographic location to infants who did not have an RSV hospitalization before 6 months of age. Results: For every 1 log2 increase in titer of cord blood RSV neutralizing antibodies there was a 30{\%} reduced risk of hospitalization with RSV (OR = 0.69, P = 0.003). However, among infants hospitalized with RSV, there was no association between cord blood RSV neutralizing antibody and the severity of the RSV illness. Conclusions: These findings indicate that American Indian infants with high concentrations of maternally derived RSV neutralizing antibodies are protected from RSV hospitalization before 6 months of age. However, these antibodies do not modify the severity of illness once disease has occurred. The basis for elevated rates of RSV disease among American Indian infants cannot be attributed to a failure of maternal RSV neutralizing antibodies to confer protection.",
keywords = "American Indians, Infants, Neutralizing antibody, Respiratory syncytial virus",
author = "Angelia Eick and Karron, {Ruth A} and Jana Shaw and Bhagvanji Thumar and Raymond Reid and Mathuram Santosham and O'Brien, {Katherine L}",
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T1 - The role of neutralizing antibodies in protection of American Indian infants against respiratory syncytial virus disease

AU - Eick, Angelia

AU - Karron, Ruth A

AU - Shaw, Jana

AU - Thumar, Bhagvanji

AU - Reid, Raymond

AU - Santosham, Mathuram

AU - O'Brien, Katherine L

PY - 2008/3

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N2 - Background: Navajo and White Mountain Apache infants have respiratory syncytial virus (RSV) hospitalization rates 2-5 times that of the general U.S. infant population. To evaluate whether these high rates can be attributable to low concentrations of maternally derived RSV neutralizing antibodies, we conducted a case-control study. Methods: Study subjects enrolled in a prospective, hospital-based surveillance study of RSV disease and a group randomized clinical trial of a 7-valent pneumococcal conjugate vaccine. Cord blood specimens were assayed for neutralizing RSV antibody titers. Infants hospitalized with a respiratory illness had a nasal aspirate obtained to determine whether RSV was present. Infants with an RSV respiratory hospitalization were matched by date of birth and geographic location to infants who did not have an RSV hospitalization before 6 months of age. Results: For every 1 log2 increase in titer of cord blood RSV neutralizing antibodies there was a 30% reduced risk of hospitalization with RSV (OR = 0.69, P = 0.003). However, among infants hospitalized with RSV, there was no association between cord blood RSV neutralizing antibody and the severity of the RSV illness. Conclusions: These findings indicate that American Indian infants with high concentrations of maternally derived RSV neutralizing antibodies are protected from RSV hospitalization before 6 months of age. However, these antibodies do not modify the severity of illness once disease has occurred. The basis for elevated rates of RSV disease among American Indian infants cannot be attributed to a failure of maternal RSV neutralizing antibodies to confer protection.

AB - Background: Navajo and White Mountain Apache infants have respiratory syncytial virus (RSV) hospitalization rates 2-5 times that of the general U.S. infant population. To evaluate whether these high rates can be attributable to low concentrations of maternally derived RSV neutralizing antibodies, we conducted a case-control study. Methods: Study subjects enrolled in a prospective, hospital-based surveillance study of RSV disease and a group randomized clinical trial of a 7-valent pneumococcal conjugate vaccine. Cord blood specimens were assayed for neutralizing RSV antibody titers. Infants hospitalized with a respiratory illness had a nasal aspirate obtained to determine whether RSV was present. Infants with an RSV respiratory hospitalization were matched by date of birth and geographic location to infants who did not have an RSV hospitalization before 6 months of age. Results: For every 1 log2 increase in titer of cord blood RSV neutralizing antibodies there was a 30% reduced risk of hospitalization with RSV (OR = 0.69, P = 0.003). However, among infants hospitalized with RSV, there was no association between cord blood RSV neutralizing antibody and the severity of the RSV illness. Conclusions: These findings indicate that American Indian infants with high concentrations of maternally derived RSV neutralizing antibodies are protected from RSV hospitalization before 6 months of age. However, these antibodies do not modify the severity of illness once disease has occurred. The basis for elevated rates of RSV disease among American Indian infants cannot be attributed to a failure of maternal RSV neutralizing antibodies to confer protection.

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KW - Infants

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KW - Respiratory syncytial virus

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