A Mother-to-Child Transmission Study in Nigeria: The Impact of Maternal HIV Infection and HAART on Plasma Immunoglobulins, Cytokine Profiles and Infant Outcome

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.

Keywords: Cytokine; Highly active antiretroviral therapy (HAART); Human immunodeficiency virus (HIV); Immunoglobulins; Lymphocyte stimulation; Mitogen; Prevention from mother-to-child transmission (PMTCT).

Fig. 1

Pooled total plasma IgA, IgM and IgG. A Plasma IgA (mg/dL) level in the HIV infected HARRT treated and the control pregnant mothers showed non-significant (P > 0.05) difference. B Data indicated significantly lower (P < 0.0001) total plasma IgM level in the HIV infected HAART treated pregnant mothers compared to the control group. C Total plasma IgG level in the HIV infected HARRT treated pregnant mothers was significantly (P < 0.0001) higher compared to their control group.

Fig. 2

Total plasma IgA, IgM and IgG at 1st, 2nd and 3rd Trimester. A There was non-significant—ns (P > 0.05) difference in plasma IgA through 1st, 2nd and 3rd trimesters in the HIV⁺ HAART treated and control subjects. B Plasma IgM in the HIV⁺ HAART treated pregnant women and control subjects showed non-significant (ns) difference (P > 0.05) throughout 1st, 2nd and 3rd trimester. C Plasma IgG levels at 1st and 3rd trimesters in the HIV infected HAART treated pregnant women were significantly higher (P = 0.0005; P < 0.0001) than that in the control group.