Impact of maternal HIV infection and placental malaria on the transplacental transfer of influenza antibodies in mother-infant pairs in Malawi, 2013-2014

Antonia Ho, Gugulethu Mapurisa, Mwayiwawo Madanitsa, Linda Kalilani-Phiri, Steve Kamiza, B Makanani, Feiko O Ter Kuile, Amelia Buys, Florette Treurnicht, Dean Everett, Victor Mwapasa, Marc-Alain Widdowson, Meredith Mcmorrow, Robert S Heyderman

Research output: Contribution to journalA1: Web of Science-article

Abstract

Background: Maternal influenza vaccination protects infants against influenza virus infection. Impaired transplacental transfer of influenza antibodies may reduce this protection.

Methods: We conducted a cross-sectional study of influenza vaccine-naïve pregnant women recruited at delivery from Blantyre (urban, low malaria transmission) and Chikwawa (rural, high malaria transmission) in Southern Malawi. HIV-infected mothers were excluded in Chikwawa. Maternal and cord blood antibodies against circulating influenza strains A/California/7/2009, A/Victoria/361/2011, B/Brisbane/60/2008, and B/Wisconsin/1/2010 were measured by hemagglutination inhibition (HAI). We studied the impact of maternal HIV infection and placental malaria on influenza antibody levels in mother-infant pairs in Blantyre and Chikwawa, respectively.

Results: We included 454 mother-infant pairs (Blantyre, n = 253; Chikwawa, n = 201). HIV-infected mothers and their infants had lower seropositivity (HAI titer ≥1:40) against influenza A(H1N1)pdm09 (mothers, 24.3 vs 45.4%; P = .02; infants, 24.3 vs 50.5%; P = .003) and A(H3N2) (mothers, 37.8% vs 63.9%; P = .003; infants, 43.2 vs 64.8%; P = .01), whereas placental malaria had an inconsistent effect on maternal and infant seropositivity. In multivariable analyses, maternal HIV infection was associated with reduced infant seropositivity (A(H1N1)pdm09: adjusted odds ratio [aOR], 0.34; 95% confidence interval [CI], 0.15-0.79; A(H3N2): aOR, 0.43; 95% CI, 0.21-0.89). Transplacental transfer was not impaired by maternal HIV or placental malaria.

Conclusions: Maternal HIV infection influenced maternal antibody response to influenza A virus infection, and thereby antibody levels in newborns, but did not affect transplacental antibody transfer.

Original languageEnglish
JournalOpen Forum Infectious Diseases
Volume6
Issue number10
Pages (from-to)ofz383
Number of pages10
ISSN2328-8957
DOIs
Publication statusPublished - 2019

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