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- Title
Respiratory Syncytial Virus (RSV) Neutralizing Antibodies at Birth Predict Protection from RSV Illness in Infants in the First 3 Months of Life.
- Authors
Buchwald, Andrea G; Graham, Barney S; Traore, Awa; Haidara, Fadima Cheick; Chen, Man; Morabito, Kaitlyn; Lin, Bob C; Sow, Samba O; Levine, Myron M; Pasetti, Marcela F; Tapia, Milagritos D
- Abstract
Background Respiratory syncytial virus (RSV) is a leading cause of viral pneumonia and bronchiolitis during the first 6 months of life. Placentally transferred antibodies can prevent severe RSV illness, and maternal immunization may reduce illness in young infants. Identification of protective antibody levels facilitates the advancement of vaccine candidates and maternal immunization. Methods We conducted a nested case-control study with 587 Malian mother–infant pairs, followed from birth to age 6 months. RSV cases were infants who developed influenza-like illness (ILI) or pneumonia and were RSV-positive by polymerase chain reaction. Cases were matched to healthy controls and RSV-negative ILI controls. RSV-A and RSV-B neutralizing antibodies were measured in maternal, cord blood, and infant sera at age 3 and 6 months. Results Maternal antibodies were efficiently transferred to infants. Maternal and infant RSV titers were strongly correlated. Infant antibody titers against RSV-A were 3 times higher than those against RSV-B. At birth, infants who remained healthy had significantly higher RSV-A and RSV-B titers compared with infants who subsequently contracted RSV. RSV-A inhibitory concentration (IC)80 titer >239 or RSV-B titer >60 at birth was significantly associated with being a healthy control compared with an RSV case within the first 3 months of life. RSV-A IC80 titers in cord blood were associated with decreased episodes of pneumonia. Conclusions Maternally acquired RSV antibodies were associated with protection of infants against community-detected cases of RSV-ILI and pneumonia. RSV titers in cord blood can predict whether an infant will be infected with RSV or remain uninfected.
- Subjects
CHILDBIRTH; VIRAL pneumonia; IMMUNOGLOBULINS; SERUM; CASE-control method; CORD blood; RESPIRATORY syncytial virus infections; VIRAL antibodies; POLYMERASE chain reaction; CHILDREN
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 11, pe4421
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa648