Limits...
Factors affecting the infant antibody response to measles immunisation in Entebbe-Uganda.

Kizito D, Tweyongyere R, Namatovu A, Webb EL, Muhangi L, Lule SA, Bukenya H, Cose S, Elliott AM - BMC Public Health (2013)

Bottom Line: In a multivariate regression analysis, factors associated with reduced measles-specific antibody levels in infancy were maternal malaria infection, infant malaria parasitaemia, infant HIV and infant wasting.Malaria and HIV infection in mothers during pregnancy, and in their infants, along with infant malnutrition, may result in reduction of the antibody response to measles immunisation in infancy.This re-emphasises the importance of malaria and HIV control, and support for infant nutrition, as these interventions may have benefits for vaccine efficacy in tropical settings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Co-infection Studies Programme, MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, PO BOX 49, Entebbe, Uganda. dennison.kizito@mrcuganda.org

ABSTRACT

Background: Vaccine failure is an important concern in the tropics with many contributing elements. Among them, it has been suggested that exposure to natural infections might contribute to vaccine failure and recurrent disease outbreaks. We tested this hypothesis by examining the influence of co-infections on maternal and infant measles-specific IgG levels.

Methods: We conducted an observational analysis using samples and data that had been collected during a larger randomised controlled trial, the Entebbe Mother and Baby Study (ISRCTN32849447). For the present study, 711 pregnant women and their offspring were considered. Helminth infections including hookworm, Schistosoma mansoni and Mansonella perstans, along with HIV, malaria, and other potential confounding factors were determined in mothers during pregnancy and in their infants at age one year. Infants received their measles immunisation at age nine months. Levels of total IgG against measles were measured in mothers during pregnancy and at delivery, as well as in cord blood and from infants at age one year.

Results: Among the 711 pregnant women studied, 66% had at least one helminth infection at enrolment, 41% had hookworm, 20% M. perstans and 19% S. mansoni. Asymptomatic malaria and HIV prevalence was 8% and 10% respectively. At enrolment, 96% of the women had measles-specific IgG levels considered protective (median 4274 mIU/ml (IQR 1784, 7767)). IgG levels in cord blood were positively correlated to maternal measles-specific IgG levels at delivery (r = 0.81, p < 0.0001). Among the infants at one year of age, median measles-specific IgG levels were markedly lower than in maternal and cord blood (median 370 mIU/ml (IQR 198, 656) p < 0.0001). In addition, only 75% of the infants had measles-specific IgG levels considered to be protective. In a multivariate regression analysis, factors associated with reduced measles-specific antibody levels in infancy were maternal malaria infection, infant malaria parasitaemia, infant HIV and infant wasting. There was no association with maternal helminth infection.

Conclusion: Malaria and HIV infection in mothers during pregnancy, and in their infants, along with infant malnutrition, may result in reduction of the antibody response to measles immunisation in infancy. This re-emphasises the importance of malaria and HIV control, and support for infant nutrition, as these interventions may have benefits for vaccine efficacy in tropical settings.

Show MeSH

Related in: MedlinePlus

Measles-specific IgG antibody levels in cord, infants and their mothers. Paired t-test values.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3733798&req=5

Figure 1: Measles-specific IgG antibody levels in cord, infants and their mothers. Paired t-test values.

Mentions: The Median (IQR) measles-specific antibody levels in mothers at enrolment and delivery, and in cord blood, were very similar (4274 mIU /ml (IQR 1784, 7767), 4079 mIU/ml (IQR 1802, 7854) and 4176 mIU/ml (IQR 1932, 8247), respectively), although the mean level at delivery was slightly lower than the level in cord blood (paired t-test p = 0.02; Figure 1). Maternal measles-specific IgG antibody levels were highly correlated between enrolment and delivery (r = 0.81; p < 0.0001). Maternal and cord blood measles specific IgG levels were also highly correlated (r = 0.82; p < 0.0001). Of the women enrolled in the study, 96% had measles-specific IgG levels within the protective range at enrolment.


Factors affecting the infant antibody response to measles immunisation in Entebbe-Uganda.

Kizito D, Tweyongyere R, Namatovu A, Webb EL, Muhangi L, Lule SA, Bukenya H, Cose S, Elliott AM - BMC Public Health (2013)

Measles-specific IgG antibody levels in cord, infants and their mothers. Paired t-test values.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3733798&req=5

Figure 1: Measles-specific IgG antibody levels in cord, infants and their mothers. Paired t-test values.
Mentions: The Median (IQR) measles-specific antibody levels in mothers at enrolment and delivery, and in cord blood, were very similar (4274 mIU /ml (IQR 1784, 7767), 4079 mIU/ml (IQR 1802, 7854) and 4176 mIU/ml (IQR 1932, 8247), respectively), although the mean level at delivery was slightly lower than the level in cord blood (paired t-test p = 0.02; Figure 1). Maternal measles-specific IgG antibody levels were highly correlated between enrolment and delivery (r = 0.81; p < 0.0001). Maternal and cord blood measles specific IgG levels were also highly correlated (r = 0.82; p < 0.0001). Of the women enrolled in the study, 96% had measles-specific IgG levels within the protective range at enrolment.

Bottom Line: In a multivariate regression analysis, factors associated with reduced measles-specific antibody levels in infancy were maternal malaria infection, infant malaria parasitaemia, infant HIV and infant wasting.Malaria and HIV infection in mothers during pregnancy, and in their infants, along with infant malnutrition, may result in reduction of the antibody response to measles immunisation in infancy.This re-emphasises the importance of malaria and HIV control, and support for infant nutrition, as these interventions may have benefits for vaccine efficacy in tropical settings.

View Article: PubMed Central - HTML - PubMed

Affiliation: Co-infection Studies Programme, MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, PO BOX 49, Entebbe, Uganda. dennison.kizito@mrcuganda.org

ABSTRACT

Background: Vaccine failure is an important concern in the tropics with many contributing elements. Among them, it has been suggested that exposure to natural infections might contribute to vaccine failure and recurrent disease outbreaks. We tested this hypothesis by examining the influence of co-infections on maternal and infant measles-specific IgG levels.

Methods: We conducted an observational analysis using samples and data that had been collected during a larger randomised controlled trial, the Entebbe Mother and Baby Study (ISRCTN32849447). For the present study, 711 pregnant women and their offspring were considered. Helminth infections including hookworm, Schistosoma mansoni and Mansonella perstans, along with HIV, malaria, and other potential confounding factors were determined in mothers during pregnancy and in their infants at age one year. Infants received their measles immunisation at age nine months. Levels of total IgG against measles were measured in mothers during pregnancy and at delivery, as well as in cord blood and from infants at age one year.

Results: Among the 711 pregnant women studied, 66% had at least one helminth infection at enrolment, 41% had hookworm, 20% M. perstans and 19% S. mansoni. Asymptomatic malaria and HIV prevalence was 8% and 10% respectively. At enrolment, 96% of the women had measles-specific IgG levels considered protective (median 4274 mIU/ml (IQR 1784, 7767)). IgG levels in cord blood were positively correlated to maternal measles-specific IgG levels at delivery (r = 0.81, p < 0.0001). Among the infants at one year of age, median measles-specific IgG levels were markedly lower than in maternal and cord blood (median 370 mIU/ml (IQR 198, 656) p < 0.0001). In addition, only 75% of the infants had measles-specific IgG levels considered to be protective. In a multivariate regression analysis, factors associated with reduced measles-specific antibody levels in infancy were maternal malaria infection, infant malaria parasitaemia, infant HIV and infant wasting. There was no association with maternal helminth infection.

Conclusion: Malaria and HIV infection in mothers during pregnancy, and in their infants, along with infant malnutrition, may result in reduction of the antibody response to measles immunisation in infancy. This re-emphasises the importance of malaria and HIV control, and support for infant nutrition, as these interventions may have benefits for vaccine efficacy in tropical settings.

Show MeSH
Related in: MedlinePlus