Abstract
Prevention of mother-to-child transmission (PMTCT) of HIV with highly active antiretroviral therapy (HARRT) allows the HIV+ pregnant mothers to have vaginal delivery and breastfeed. Here we investigated the maternal plasma immunoglobulin, cytokine secretion and the outcome of the exposed infants among the HIV+ HAART treated pregnant women in Nigeria. In this study, different plasma immunoglobulins and cytokines were measured in the HIV+ HAART treated pregnant mothers. Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ, IL-10 and IL-4. There were lower IFN-γ and IL-10 secretions at 1st trimester; however, IL-10 continued to be lower throughout 2nd and 3rd trimesters. TNF-α secretion significantly decreased as pregnancy progressed to term. There were high plasma IgG and low IgM in the HIV+ HAART treated pregnant women. Plasma IgG was high during 1st and 3rd trimesters. After one year of follow up, all the exposed children were seronegative for HIV-1 and HIV-2. Vaginal delivery and breastfeeding among HIV+ HAART treated mothers have shown to be safe. The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Borges-Almeida E, Milanez HM, Vilela MM, Cunha FG, Abramczuk BM, Reis-Alves SC, Metze K, Lorand-Metze I (2011) The impact of maternal HIV infection on cord blood lymphocyte subsets and cytokine profile in exposed non-infected newborns. BMC Infect Dis 11:38
Burns WR, Wang Y, Tang PC, Ranjbaran H, Iakimov A, Kim J, Cuffy M, Bai Y, Pober JS, Tellides G (2005) Recruitment of CXCR3+ and CCR5+ T cells and production of interferon-gamma-inducible chemokines in rejecting human arteries. Am J Transpl 5:1226–1236
Clerici M, Seminari E, Suter F, Castelli F, Pan A, Biasin M, Colombo F, Trabattoni D, Maggiolo F, Carosi G, Maserati R (2000) Different immunologic profiles characterize HIV infection in highly active antiretroviral therapy-treated and antiretroviral-naive subjects with undetectable viremia. AIDS 14:109–116
Fasawe O, Avila C, Shaffer N, Schouten E, Chimbwandira F, Hoos D, Nakakeeto O, De Lay P (2013) Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi. PLoS ONE 8:e57778
Fiore S, Newell ML, Trabattoni D, Thorne C, Gray L, Savasi V, Tibaldi C, Ferrazzi E, Clerici M (2006) Antiretroviral therapy-associated modulation of Th1 and Th2 immune responses in HIV-infected pregnant women. J Reprod Immunol 70:143–150
Gregory GD, Raju SS, Winandy S, Brown MA (2006) Mast cell IL-4 expression is regulated by Ikaros and influences encephalitogenic Th1 responses in EAE. J Clin Invest 116:1327–1336
Ifeanyichukwu M, Meludu S, Ele P, Ukibe N, Onyenekwe C, Ezeani M, Ezechukwu C, Amilo G, Umeanaeto P (2010) Evaluation of some cellular immune index in HIV infected participants. Int J Biol Chem Sci 5:1310–1315
Ifeanyichukwu OM, Bright EO, Meludu SC, Okeke CC (2016) Effect of HIV infection on some hematological parameters and immunoglobulin levels in HIV patients in Benin city. South Nigeria J HIV Retrovir 2:2
Iyer SS, Cheng G (2012) Role of interleukin 10 transcriptional regulation in inflammation and autoimmune disease. Crit Rev Immunol 32:23–63
Kindra G, Coutsoudis A, Esposito F, Esterhuizen T (2012) Breastfeeding in HIV exposed infants significantly improves child health: a prospective study. Matern Child Health J 16:632–640
Kunzmann S, Collins JJ, Kuypers E, Kramer BW (2013) Thrown off balance: the effect of antenatal inflammation on the developing lung and immune system. Am J Obstet Gynecol 208:429–437
Lo MS, Zurakowski D, Son MBF, Sundel RP (2013) Hypergammaglobulinemia in the pediatric population as a marker for underlying autoimmune disease: a retrospective cohort study. Pediatr Rheumatol Online J 11:42
Mosser DM, Zhang X (2008) Interleukin-10: new perspectives on an old cytokine. Immunol Rev 226:205–218
Müller F, Tjonnfjord GE, Nordoy I, Kvale D, Mellbye OJ, Aukrust R, Froland SS (2002) Immunophenotypic analyses of CD34+ cell subsets in bone marrow from HIV-infected subjects during highly active antiretroviral therapy. Eur J Clin Invest 32:535–540
Onyenekwe C, Ele P, Ukibe N, Ezeani M, Ezechukwu C, Amilo G, Pauline U, Ifeanyichukwu M (2010) Assessment of white blood cell count, packed cell volume, phagocytic functions, serum albumin and plasma iron in HIV infected subjects. Clin Immunol 135:S110
Pacheco SE, McIntosh K, Ming L, Mofenson LM, Diaz C, Foca M, Frederick M, Handelsman E, Hayani K, Shearer WT (2006) Women and infants transmission study: effect of perinatal antiretroviral drug exposure on hematologic values in HIV-uninfected children: an analysis of the women and infant’s transmission study. J Infect Dis 194:1089–1097
Saraiva M, O’Garra A (2010) The regulation of IL-10 production by immune cells. Nat Rev Immunol 10:170–181
Sibeko L, Coutsoudis A, Nzuza S, Gray-Donald K (2009) Mothers’ infant feeding experiences: constraints and supports for optimal feeding in an HIV-impacted urban community in South Africa. Public Health Nutr 12:1983–1990
The Joint United Nations Programme on HIV and AIDS (UNAIDS) (2017) Ending AIDS: progress towards the 90-90-90 argets. https://www.unaids.org/en/resources/documents/2017/20170720_Global_AIDS_update_2017. Accessed 23 May 2019
The Joint United Nations Programme on HIV and AIDS (UNAIDS) (2018) Miles to go: global AIDS update 2018. https://www.unaids.org/en/20180718_GR2018. Accessed 5 May 2019
The United Nations Children’s Fund (UNICEF) (2005) HIV and infant feeding. https://www.unicef.org/nutrition/index_24827.html. Assessed 10 May 2019
WHO, UNICEF, UNAIDS, UNFPA (2010) Guidelines on HIV and infant feeding: principles and recommendations for infant feeding in the context of HIV and a summary of evidence, Geneva. https://www.who.int/nutrition/publications/HIV_IF_guide_for_healthcare.pdf. Accessed 3 Oct 2019
World Health Organization (WHO) (2015) Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva. http://www.who.int/hiv/pub/guidelines/earlyrelease-arv/en/. Accessed 8 July 2019
Yamada H, Morikawa M, Furuta I, Kato EH, Shimada S, Iwabuchi K (2003) Intravenous immunoglobulin treatment in women with recurrent abortions: increased cytokine levels and reduced Th1/Th2 lymphocyte ratio in peripheral blood. Am J Reprod Immunol 49(2):84–89
Acknowledgements
This work was partly supported by TETFUND Nigeria through Ebonyi State University (EBSU) Abakaliki. We thank Prof. EO Ekumankama, former DVC of EBSU for his effort to see that grants were secured to complete the study in the United States of America.
Author information
Authors and Affiliations
Contributions
COE-A and CCO did conception and design of the work. COE-A interviewed the patients and collected samples. COE-A and OU did sample shipment. COE-A and LR analyzed samples. COE-A and PM did follow-up on the exposed infants. COE-A, LR and CCO interpreted the patient data. COE-A, LR and CCO were a major contributor in writing the manuscript. COE-A, LR checked and finalized the manuscript. All authors read and approved the final manuscript.
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Animal and Human Rights Statement
Additional informed consent was obtained from all patients for which identifying information is included in this article. Ethical clearance was obtained from the Ethical Committee of the Department of Medical Laboratory Science, Faculty of Health Science, Nnamdi Azikiwe University, Nnewi Nigeria. Ethical approval letter to see the subjects was obtained from ethical committee of Mother of Christ Specialist, Hospital, Ogui Enugu, Nigeria. The aim of the research was explained to all the HIV+ HAART treated pregnant women and the control pregnant women seen at the PMTCT clinic and antenatal clinics of Mother of Christ Specialist, Hospital, Ogui Enugu, Nigeria. All the subjects were allowed to participate willingly and withdrawal at any time was allowed. All subjects filled a questionnaire and signed a consent form before blood samples were collected. Procedures followed were in accordance with the ethical standards of the Helsinki Declaration (1964, amended most recently in 2008), which was created by the World Medical Association. Ethical clearance letters are attached.
Rights and permissions
About this article
Cite this article
Ewenighi-Amankwah, C.O., Onyenekwe, C.C., Udemba, O. et al. A Mother-to-Child Transmission Study in Nigeria: The Impact of Maternal HIV Infection and HAART on Plasma Immunoglobulins, Cytokine Profiles and Infant Outcome. Virol. Sin. 35, 468–477 (2020). https://doi.org/10.1007/s12250-020-00202-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12250-020-00202-9