4.7 Article

Reduction of Antimalarial Antibodies by HIV Infection Is Associated With Increased Risk of Plasmodium falciparum Cord Blood Infection

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 205, Issue 4, Pages 568-577

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jir815

Keywords

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Funding

  1. Instituto de Salud Carlos III [PS09/01113, CP-04/00220, BF-03/00106]
  2. Banco de Bilbao
  3. Vizcaya
  4. Argentaria Foundation [BBVA02-0]
  5. Ministerio de Ciencia e Innovacion [RYC-2008-02631]
  6. Spanish Agency for International Cooperation

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Background. Plasmodium falciparum infection in pregnancy can lead to congenital malaria, which has detrimental health consequences for infants. Human immunodeficiency virus (HIV) might increase cord blood P. falciparum infection by decreasing maternal antimalarial-specific antibodies. Methods. HIV-negative (n=133) and HIV-positive (n=55) Mozambican pregnant women were assessed at delivery for maternal and cord P. falciparum infection by quantitative polymerase chain reaction (qPCR) and P. falciparum-specific antibodies by enzyme-linked immunosorbent assay and flow cytometry. Results. Prevalence of qPCR-detected cord blood infection was 8.0%. Risk of cord infection was increased in presence of HIV (adjusted odds ratio [AOR], 3.80; P=.04) and placental malaria (AOR, 22.08; P=.002) after adjusting for clinical variables. The odds of having a high immunoglobulin G response to chondrotin sulphate A-binding infected erythrocytes, parasite lysate, and erythrocyte-binding antigen-175 were reduced among HIV-positive women (P < .001, .048, and .056, respectively) and among women with cord P. falciparum infection (P = .009, .04, and .046, respectively). In multivariate analysis including maternal HIV status, placental malaria, and antibody responses, HIV was no longer associated with cord blood infection (P = .11). Conclusions. HIV-associated impairment of antibody responses in pregnant women may contribute to a higher transmission of P. falciparum to their infants.

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