Efficiency of transplacental transfer of respiratory syncytial virus (RSV) specific antibodies among pregnant women in Kenya

Wellcome Open Research

article

Joyce U. Nyiro¹  Elizabeth Bukusi²  Dufton Mwaengo³  Amek Nyaguara¹  Bryan Nyawanda⁴  Nancy Otieno⁴  Godfrey Bigogo⁴  Nickson Murunga¹  Marc-Alain Widdowson⁵  Jennifer R. Verani⁷  Sandra S. Chaves⁵  Hope Mwangudza¹  Calleb Odundo¹  James A. Berkley¹  D James Nokes¹  Patrick K. Munywoki⁵ 

[1] Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute ,(KEMRI)-Wellcome Trust Research Programme;Centre for Microbiology Research, Kenya Medical Research Institute;Institute of Tropical and Infectious Diseases, University of Nairobi;Centre for Global Health Research, Kenya Medical Research Institute;Division of Global Health Protection, CDC-Kenya, U.S Centers for Disease Control and Prevention;Institute of Tropical Medicine;Influenza Division, U.S. Centers for Disease Control and Prevention;School of Life Sciences and Zeeman Institute ,(SBIDER), University of Warwick

关键词: Pregnant women;    transplacental transfer efficiency;    Respiratory Syncytial Virus;    Neutralising antibody;    Maternal vaccine;    Effectiveness;   

DOI  :  10.12688/wellcomeopenres.17636.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: Maternal immunisation to boost respiratory syncytial virus (RSV) antibodies in pregnant women, is a strategy being considered to enhance infant protection from severe RSV associated disease. However, little is known about the efficiency of transplacental transfer of RSV-specific antibodies in a setting with a high burden of malaria and HIV, to guide the implementation of such a vaccination program.Methods: Using a plaque reduction neutralization assay, we screened 400 pairs of cord and maternal serum specimens from pregnant women for RSV-specific antibodies. Participants were pregnant women of two surveillance cohorts: 200 participants from a hospital cohort in Kilifi, Coastal Kenya and 200 participants from a surveillance cohort in Siaya, Western Kenya. Transplacental transfer efficiency was determined by the cord to maternal titre ratio (CMTR). Logistic regression was used to determine independent predictors of impaired transplacental transfer of RSV-specific antibodies.Results: A total of 800 samples were screened from the 400 participants. At enrollment the median age was 25 years (Interquartile range (IQR): 21-31). Overall, transplacental transfer was efficient and did not differ between Kilifi and Siaya cohort (1.02 vs. 1.02; p=0.946) but was significantly reduced among HIV-infected mothers compared to HIV-uninfected mothers (mean CMTR: 0.98 vs 1.03; p=0.015). Prematurity <33 weeks gestation (Odds ratio [OR]: 0.23, 95% confidence interval [CI] 0.06–0.85; p=0.028), low birth weight <2.5 kgs (OR: 0.25, 95% CI: 0.07–0.94; p=0.041) and HIV infection (OR: 0.47, 95% CI:0.23-0.98; p=0.045) reduced efficiency of transplacental transfer among these women.Conclusions: Transplacental transfer of RSV-specific antibodies among pregnant women in Kenya is efficient. A consideration to integrate other preventive interventions with maternal RSV vaccination targeting infants born premature (<33 weeks gestation), with low birth weight <2.5 kgs, or HIV-infected mothers is likely to improve vaccine outcomes in this setting.

【 授权许可】

CC BY