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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The effect of intermittent preventive treatment during pregnancy on malarial antibodies depends on HIV status and is not associated with poor delivery outcomes
Journal of Infectious Diseases, Volume 201, No. 1, Year 2010
Notification
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Description
Background. Intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for malaria prevention in sub-Saharan Africa. However, studies reporting the effect of IPTp on malaria-specific immunity are scarce and are based on findings in human immunodeficiency virus (HIV)-negative Primigravidae. Methods. Plasma samples obtained from 302 pregnant women (177 who were HIV negative, 88 who were HIV positive, and 37 who were of unknown HIV status) participating in a placebo-controlled trial of IPTp with SP (IPTp-SP) were analyzed for the presence of antibodies against merozoite antigens, whole asexual parasites, and variant surface antigens from chondroitin sulfate A-binding and nonbinding lines. Antibody levels were compared between intervention groups, and their association with morbidity outcomes was assessed. Results. HIV-positive mothers receiving SP had lower levels of peripheral antibodies against apical membrane antigen-1 and variant surface antigens, as well as lower levels of cord antibodies against erythrocyte-binding antigen-175 and parasite lysate, than did HIV-positive placebo recipients. No difference between intervention groups was observed among HIV-negative mothers. High antibody levels were associated with maternal infection and an increased risk of a first malaria episode in infants. Antibody responses were not consistently associated with reduced maternal anemia, prematurity, or low birth weight. Conclusions. The IPTp-associated reduction in antibodies in HIV-infected women, but not in HIV-uninfected women, may reflect a higher efficacy of the intervention in preventing malaria among HIV-positive mothers. This reduction did not translate into an enhanced risk of malaria-associated morbidity in mothers and infants. Trial registration. Clinicaltrials.gov identifier NCT00209781. © 2009 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Serra-Casas, Elisa
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Menéndez, Clara
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Bardají, Azucena
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Quintò, Llorenç L.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Dobaño, Carlota
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Sigaúque, Betuel
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Jiménez, Alfons
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mandomando, Inácio M.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Chauhan, Virander Singh
Italy, Trieste
International Centre for Genetic Engineering and Biotechnology
Chitnis, Chetan E.
Italy, Trieste
International Centre for Genetic Engineering and Biotechnology
Alonso, Pedro Luís
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mayor, A. G.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Spain, Barcelona
Universitat de Barcelona
Statistics
Citations: 53
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1086/648595
ISSN:
00221899
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Participants Gender
Female