Infant models were adjusted for maternal age and gravidity, infant Apgar score 7 and birth weight (Kg)

Infant models were adjusted for maternal age and gravidity, infant Apgar score 7 and birth weight (Kg). infection compromises transplacental transfer. Reassessment of maternal and/or infant pneumococcal immunization strategies is needed in HIV-infected women and their infants. Keywords: pneumococcus, antibodies, serotypes, maternal, cord, transplacental transfer, HIV, India, Bangladesh Imrecoxib Background Diseases caused by (Spn), also Imrecoxib known as pneumococcus, kill 700,000 to 1 1 million people annually, and contribute to 11% of all deaths in children under 5. [1] India shoulders the largest number of pneumococcal cases and deaths in children.[1, 2] Pneumonia, bacteremia, and meningitis are the most common manifestations of invasive pneumococcal disease (IPD). Spn within the respiratory tract can also cause otitis media, sinusitis or bronchitis. In non-immunized populations, Spn accounts for approximately 15C50% of community-acquired pneumonia, 30C50% of acute otitis media, and a significant proportion of meningitis and bacteremia events globally. Children less than 2 years are at greatest risk for pneumococcal infection, particularly IPD. [1, 3] Serotypes represented in current pneumococcal vaccines (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) account for more than 80% of IPD.[4, 5] Serotypes 6B and 14 are also important in otitis media and nasopharyngeal colonization, respectively. Several factors are associated with increased risk of pneumococcal infection, including HIV disease, nasopharyngeal colonization and low anti-capsular specific IgG antibody levels.[6, 7] Protection of young infants, who are at high risk of pneumococcal disease, depends to a large extent on Spn IgG antibodies acquired from maternal-fetal transfer. Transfer of these antibodies occurs late in pregnancy and is generally protective during the first 3C6 months of life in infants (median antibody half-life is 35 days). [8, 9] The umbilical cord IgG antibody concentrations are a standard measure of maternally acquired IgG antibodies. Previous research has shown that HIV is associated with Imrecoxib reduced levels of pneumococcal antibodies in women, but the effect of HIV on transplacental transfer of serotype-specific antibodiesincluding whether the amount transferred to the infant is sufficient to protect against diseaseis less clear. Studies from South Africa and Brazil reported decreased mother-to-infant transfer of total anti-polysaccharide pneumococcal IgG in HIV-infected versus uninfected women, but did not stratify by serotype. Imrecoxib [31, 34] Another Rabbit Polyclonal to HDAC3 study in Brazil showed decreased transplacental antibody transfer of serotypes 6B, 9V and 14, but did not examine the impact of maternal HIV infection. [29]. India does not routinely provide pneumococcal vaccination for children or HIV-infected adults. Therefore, the objectives of our study were to: (1) determine levels of naturally occurring maternal serotype-specific Spn antibodies in HIV-infected versus HIV-uninfected pregnant women; (2) determine the degree of transplacental transfer of these antibodies from mother to infant; and (3) assess if the degree of transplacental antibody transfer should confer protection to infants against Spn serotypes associated with IPD and pneumococcal nasopharyngeal colonization. To assess the impact of HIV on transplacental antibody transfer, we also performed the same measurements in HIV-negative women in neighboring Bangladesh, for whom data were Imrecoxib readily available. Demonstrating low levels of natural protection against pneumococcus would emphasize the need to develop novel immunization strategies for HIV-infected mothers and their HIV-exposed newborns to reduce Spn-related morbidity and mortality in these high-risk populations. Methods Study population We retrospectively analyzed maternal-cord serum samples from 74 HIV-infected women who were enrolled into a prevention of mother-to-child HIV transmission trial (SWEN) in India. The eligibility criteria and parent study methods are described in detail elsewhere. [10] Pregnant women were at least 18 years of age, HIV-infected and enrolled at Byramjee Jeejeebhoy Government Medical College (BJGMC), a 1300-bed public hospital in Pune, India, between August 2002 and September 2007.[10] Samples were tested for Spn IgG levels as described below. None of the women had received the pneumococcal vaccine, as per standard of care in India. For the purposes of this analysis, we included the available subset of maternal serum samples that were collected within 4 weeks (median days.