440. Maternal and Child Cytomegalovirus-Neutralizing Antibody Levels and HIV-infected Women and the Newborns
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 440_IDWPOSTER_update.pdf (8.5 MB)
  • Background: Human cytomegalovirus (HCMV) is the most common congenital viral infection in the US leading to serious complications and central nervous system disease. For pregnant women suspected to have primary HCMV infection treatment with hyperimmune globulin and/or antivirals may be utilized to prevent mother-to-infant transmission. Effective vaccine is currently unavailable. In this study, we investigated whether presence of maternal and infant HCMV-neutralizing antibody (NAb) were associated with HCMV viremia in the newborn infant.

     Methods: 76 HIV+ women and their newborns enrolled in a Natural History study of HIV and the role of HCMV on HIV pathogenesis at our Maternal, Child and Adolescent Center were studied. Maternal plasma and infant cord blood were assessed for presence of NAb and HCMV viremia. A novel ELISA microneutralization assay was used to quantify NAb levels using serially diluted plasma, which was incubated with HCMV AD169, followed by overnight incubation with human fibroblast cells. After 3 days, cells were fixed and an in situ ELISA assay was performed to assess for neutralization compared to controls. HCMV viremia was detected by Abbott RealTime HCMV assay. Statistical analyses were performed with Prism 5.0.

    Results: For the 76 HIV mothers, mean NAb levels were 246.2 (reciprocal titers); 41% had no evidence of NAb; 19 (25%) women had presence of viremia and among those with viremia 7/19 (37%) had undetectable NAb levels. Among the newborns 19/76 (25%) were found to have HCMV viremia. NAb levels in the newborn babies with HCMV viremia were higher than those without viremia. Maternal neutralizing antibody levels were significantly correlated with infant NAb levels (P < 0.0001) and HCMV viremia levels (P = 0.018) in newborns.

    Conclusion: Maternal neutralizing antibody levels appear to be related to levels of NAb and HCMV viremia in newborn babies. Those with NAb were more likely to have detectable HCMV viremia in their children. These findings may help develop more effective treatment protocols in the future. Furthermore, the development of the quantification assay has allowed us to detect levels of effective antibody in the plasma, which we believe is more informative than commercial assays that only detect total antibody levels.

    Chi-Lin Lee, Ph.D1, Beth Swift-Taylor2, Toni Frederick, PhD3, Zhi Chun Chen, Ph.D4, Kasalyn Thuvamontolrat4 and Andrea Kovacs, MD5, (1)Pediatrics, University of Southern California, Los Angeles, CA, (2)Keck School of Medicine, University of Southern California, Los Angeles, CA, (3)Research Pediatrics, University of Southern California, Los Angeles, CA, (4)University of Southern California, Los Angeles, CA, (5)Pediatrics, Keck School of Medicine at USC, Los Angeles, CA

    Disclosures:

    C. L. Lee, None

    B. Swift-Taylor, None

    T. Frederick, None

    Z. C. Chen, None

    K. Thuvamontolrat, None

    A. Kovacs, None

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