HIV-exposed Infants with EBV Infection Have a Reduced Persistence of the Immune Response to the HBV Vaccine

Overview

Journal AIDS Res Ther

Publisher Biomed Central

Specialty Infectious Diseases

Date 2021 Aug 5

PMID 34348748

Citations 4

Authors

Silvia Baroncelli

Clementina Maria Galluzzo

Giuseppe Liotta

Mauro Andreotti

Stefano Orlando

Fausto Ciccacci

Robert Mphwere

Richard Luhanga

Jean Baptiste Sagno

Roberta Amici

Maria Cristina Marazzi

Marina Giuliano

Affiliations

Soon will be listed here.

Abstract

Background: In sub-Saharan African countries Epstein Barr virus (EBV) infection occurs in early childhood. We aim to investigate the factors associated with EBV acquisition and the impact of EBV infection on the humoral response to HBV vaccination in infants born from HIV-positive, antiretroviral-treated mothers in Malawi.

Methods: A total of 149 HIV-exposed infants were included in this longitudinal study. EBV anti-VCA IgG were measured using an ELISA assay. The EBV seroconversion was correlated with the maternal viro-immunological conditions, with infant growth and immunological vulnerability, and with the humoral response to the HBV vaccine.

Results: No infant was EBV-positive at 6 months (n. 52 tested). More than a third of infants (49/115 or 42.6 %) on study beyond 6 months seroconverted at 12 months. At 24 months, out of 66 tested infants, only 13 remained EBV-uninfected, while 53 (80.3 %) acquired EBV infection, rising the total proportion of EBV seroconversion to 88.7 % (102/115 infants). EBV seroconversion was significantly associated with a low maternal educational status but had no impact on infant growth or vulnerability to infections. Reduced HBsAb levels and accelerated waning of antibodies were associated with early EBV seroconversion.

Conclusions: We found a heterogeneous timing of acquisition of EBV with the majority of infants born from HIV + mothers acquiring infection after 6 months. Anti-HBs levels were lower and appeared to wane faster in infants acquiring EBV infection.

Citing Articles

Cellular and soluble plasma immune markers at presentation in multisystem inflammatory syndrome in children and Kawasaki disease in South Africa: An observational study.

Abraham D, van Coller A, Tattersall M, Mohlake E, Yunis N, Webb K Medicine (Baltimore). 2025; 104(7):e41516.

PMID: 39961004 PMC: 11835083. DOI: 10.1097/MD.0000000000041516.

Immune response to hepatitis B vaccine among children under 5 years in Africa: a meta-analysis.

Olakunde B, Ifeorah I, Adeyinka D, Olakunde O, Ogundipe T, Olawepo J Trop Med Health. 2024; 52(1):28.

PMID: 38561838 PMC: 10983738. DOI: 10.1186/s41182-024-00594-4.

Insights into the interplay between Epstein-Barr virus (EBV) and multiple sclerosis (MS): A state-of-the-art review and implications for vaccine development.

Mohammadzamani M, Kazemzadeh K, Chand S, Thapa S, Ebrahimi N, Yazdan Panah M Health Sci Rep. 2024; 7(2):e1898.

PMID: 38361801 PMC: 10867693. DOI: 10.1002/hsr2.1898.

Micronutrient and Nutritional Status of HIV-Exposed and HIV-Unexposed Malawian Infants in the First Year of Life: Assessment of Ferritin, Vitamin A, and D Status and Its Association with Growth.

Floridia M, Galluzzo C, Orlando S, Luhanga R, Mphwere R, Kavalo T Nutrients. 2023; 15(14).

PMID: 37513701 PMC: 10386663. DOI: 10.3390/nu15143282.

Human immunodeficiency virus and antiretroviral therapy-mediated immune cell metabolic dysregulation in children born to HIV-infected women: potential clinical implications.

Mataramvura H, Bunders M, Duri K Front Immunol. 2023; 14:1182217.

PMID: 37350953 PMC: 10282157. DOI: 10.3389/fimmu.2023.1182217.

References

Balfour Jr H, Sifakis F, Sliman J, Knight J, Schmeling D, Thomas W . Age-specific prevalence of Epstein-Barr virus infection among individuals aged 6-19 years in the United States and factors affecting its acquisition. J Infect Dis. 2013; 208(8):1286-93. DOI: 10.1093/infdis/jit321. View

Merani S, Pawelec G, Kuchel G, McElhaney J . Impact of Aging and Cytomegalovirus on Immunological Response to Influenza Vaccination and Infection. Front Immunol. 2017; 8:784. PMC: 5512344. DOI: 10.3389/fimmu.2017.00784. View

Lasaviciute G, Bjorkander S, Carvalho-Queiroz C, Hed Myrberg I, Nussbaum B, Nilsson C . Epstein-Barr Virus, but Not Cytomegalovirus, Latency Accelerates the Decay of Childhood Measles and Rubella Vaccine Responses-A 10-Year Follow-up of a Swedish Birth Cohort. Front Immunol. 2018; 8:1865. PMC: 5742589. DOI: 10.3389/fimmu.2017.01865. View

Zar H, Jeena P, Argent A, Gie R, Madhi S . Diagnosis and management of community-acquired pneumonia in childhood--South African Thoracic Society Guidelines. S Afr Med J. 2006; 95(12 Pt 2):977-81, 984-90. View

Cannon M, Schmid D, Hyde T . Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev Med Virol. 2010; 20(4):202-13. DOI: 10.1002/rmv.655. View

Slyker J, Casper C, Tapia K, Richardson B, Bunts L, Huang M . Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women. J Infect Dis. 2013; 207(12):1798-806. PMC: 3654744. DOI: 10.1093/infdis/jit093. View

Daud I, Coleman C, Smith N, Ogolla S, Simbiri K, Bukusi E . Breast Milk as a Potential Source of Epstein-Barr Virus Transmission Among Infants Living in a Malaria-Endemic Region of Kenya. J Infect Dis. 2015; 212(11):1735-42. PMC: 4633760. DOI: 10.1093/infdis/jiv290. View

Chene A, Donati D, Orem J, Mbidde E, Kironde F, Wahlgren M . Endemic Burkitt's lymphoma as a polymicrobial disease: new insights on the interaction between Plasmodium falciparum and Epstein-Barr virus. Semin Cancer Biol. 2009; 19(6):411-20. DOI: 10.1016/j.semcancer.2009.10.002. View

Giuliano M, Andreotti M, Liotta G, Jere H, Sagno J, Maulidi M . Maternal antiretroviral therapy for the prevention of mother-to-child transmission of HIV in Malawi: maternal and infant outcomes two years after delivery. PLoS One. 2013; 8(7):e68950. PMC: 3716887. DOI: 10.1371/journal.pone.0068950. View

10.

Souza T, Stollar B, Sullivan J, Luzuriaga K, Thorley-Lawson D . Influence of EBV on the peripheral blood memory B cell compartment. J Immunol. 2007; 179(5):3153-60. DOI: 10.4049/jimmunol.179.5.3153. View

11.

Slogrove A, Esser M, Cotton M, Speert D, Kollmann T, Singer J . A Prospective Cohort Study of Common Childhood Infections in South African HIV-exposed Uninfected and HIV-unexposed Infants. Pediatr Infect Dis J. 2017; 36(2):e38-e44. PMC: 5242219. DOI: 10.1097/INF.0000000000001391. View

12.

Abu-Raya B, Kollmann T, Marchant A, MacGillivray D . The Immune System of HIV-Exposed Uninfected Infants. Front Immunol. 2016; 7:383. PMC: 5039172. DOI: 10.3389/fimmu.2016.00383. View

13.

Gantt S, Orem J, Krantz E, Morrow R, Selke S, Huang M . Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants. J Infect Dis. 2016; 214(1):36-44. PMC: 4907408. DOI: 10.1093/infdis/jiw076. View

14.

Piriou E, Asito A, Sumba P, Fiore N, Middeldorp J, Moormann A . Early age at time of primary Epstein-Barr virus infection results in poorly controlled viral infection in infants from Western Kenya: clues to the etiology of endemic Burkitt lymphoma. J Infect Dis. 2012; 205(6):906-13. PMC: 3282570. DOI: 10.1093/infdis/jir872. View

15.

Pirillo M, Liotta G, Andreotti M, Jere H, Sagno J, Scarcella P . CMV infection in a cohort of HIV-exposed infants born to mothers receiving antiretroviral therapy during pregnancy and breastfeeding. Med Microbiol Immunol. 2016; 206(1):23-29. DOI: 10.1007/s00430-016-0478-6. View

16.

Biggar R, Henle W, Fleisher G, Bocker J, Lennette E, Henle G . Primary Epstein-Barr virus infections in African infants. I. Decline of maternal antibodies and time of infection. Int J Cancer. 1978; 22(3):239-43. DOI: 10.1002/ijc.2910220304. View

17.

Ruck C, Reikie B, Marchant A, Kollmann T, Kakkar F . Linking Susceptibility to Infectious Diseases to Immune System Abnormalities among HIV-Exposed Uninfected Infants. Front Immunol. 2016; 7:310. PMC: 4990535. DOI: 10.3389/fimmu.2016.00310. View

18.

Mrozek-Gorska P, Buschle A, Pich D, Schwarzmayr T, Fechtner R, Scialdone A . Epstein-Barr virus reprograms human B lymphocytes immediately in the prelatent phase of infection. Proc Natl Acad Sci U S A. 2019; 116(32):16046-16055. PMC: 6690029. DOI: 10.1073/pnas.1901314116. View

19.

Ogolla S, Daud I, Asito A, Sumba O, Ouma C, Vulule J . Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy. Clin Vaccine Immunol. 2015; 22(11):1197-205. PMC: 4622112. DOI: 10.1128/CVI.00270-15. View

20.

Mancinelli S, Pirillo M, Liotta G, Andreotti M, Mphwere R, Amici R . Antibody response to hepatitis B vaccine in HIV-exposed infants in Malawi and correlation with HBV infection acquisition. J Med Virol. 2018; 90(6):1172-1176. DOI: 10.1002/jmv.25049. View