Maternal HIV infection drives altered placental Mtb -specific antibody transfer.

Introduction: Placental transfer of maternal antibodies is essential for neonatal immunity over the first months of life. In the setting of maternal HIV infection, HIV-exposed uninfected (HEU) infants are at higher risk of developing severe infections, including active tuberculosis (TB). Given our emerging appreciation for the potential role of antibodies in the control of Mycobacterium tuberculosis ( Mtb ), the bacteria that causes TB, here we aimed to determine whether maternal HIV status altered the quality of Mtb -specific placental antibody transfer.
Methods: Antigen-specific antibody systems serology was performed to comprehensively characterize the Mtb -specific humoral immune response in maternal and umbilical cord blood from HIV infected and uninfected pregnant people in Uganda.
Results: Significant differences were noted in overall antibody profiles in HIV positive and negative maternal plasma, resulting in heterogeneous transfer of Mtb -specific antibodies. Altered antibody transfer in HIV infected dyads was associated with impaired binding to IgG Fc-receptors, which was directly linked to HIV viral loads and CD4 counts.
Conclusions: These results highlight the importance of maternal HIV status on antibody transfer, providing clues related to alterations in transferred maternal immunity that may render HEU infants more vulnerable to TB than their HIV-unexposed peers.
Competing Interests: GA is a V.P. at Moderna, a founder and equity holder of SeromYx Systems, and an employee and equity holder of Leyden Labs. GA’s interests were reviewed and are managed by MH and Partners HealthCare in accordance with their conflict-of-interest policies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Nziza, Jung, Mendu, Chen, McNamara, Fortune, Franken, Ottenhoff, Bryson, Ngonzi, Bebell and Alter.)