Program Schedule

1736
Arsenic enhances immune dysfunction and susceptibility to viral infection during pregnancy

Session: Poster Abstract Session: Public Health
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background:  We aimed to determine whether arsenic exposure during pregnancy is associated with immune dysfunction and susceptibility to viral infection during pregnancy and postpartum in a low resource setting where host exposures to immunotoxic and infectious agents coexist. 

Methods: Since 2007, the JiVitA Research Project has prospectively followed the pregnancies of ~60,000 women from Northern Bangladesh. In a sub-study of 1,100 pregnancies, IgG seroconversion to hepatitis E virus (HEV) was assessed between the 3rd trimester (TM) and 3 months postpartum. 40 women seroconverted to HEV (cases) and were matched with 40 non-seroconverting women (controls) by age-, parity-, and sector of residence. For all 80 women, we assessed urinary concentrations of inorganic arsenic plus methylated species (InAs) (µg/L) at 1st and 3rd TM and plasma concentrations of pro- and anti-inflammatory cytokines (pg/ml) at 1st TM, 3rd TM and 3 months postpartum.

Results: Among HEV seroconverters, urinary InAs was high throughout pregnancy (1st TM median=66 µg/L; interquartile range (IQR)=41-132 µg/L; 3rd TM median=65 µg/L; IQR=26-106 µg/L; p=1.0), whereas among non-seroconverters urinary InAs declined significantly during pregnancy (1st TM median=62 µg/L; IQR=37-82 µg/L; 3rd TM median=36 µg/L; IQR=26-77 µg/L; p=0.002). Among HEV seroconverters, 1st TM urinary InAs was positively associated with IL-2 in the 1st TM (beta per IQR-unit change in InAs=0.29; p<0.006) and subsequent time points (3rd TM beta=0.33, p<0.004; 3 months postpartum beta=0.17; p<0.03). The average of 1st and 3rd TM urinary InAs was also positively associated with IL-2 among HEV seroconverters at 3rd TM (beta=0.27; p=0.002) and 3 months postpartum (beta=0.16; p=0.005). Exposure-response associations between InAs and IL-2 were null among non-seroconverters.

Conclusion: Since HEV seroconversion occurred between 3rd TM and 3 months post-partum, differential arsenic exposure during pregnancy increased susceptibility to subsequent viral infection. Cytokine shifts among HEV seroconverters suggest immune responses biologically consistent with arsenic-induced immune dysfunction and viral infection. Further investigation of arsenic’s role in enhancing susceptibility to infection during pregnancy is needed, particularly immunotoxic and infectious synergies.

Christopher Heaney, MS, PhD1, Brittany Kmush, MS2, Ana Navas-Acien, MD, PhD3, Kevin Francesconi Francesconi, PhD4, Kerry Schulze, PhD2, Kenrad Nelson, MD5, Delisa Fairweather, PhD6, Sabra Klein, PhD7, Hasmot Ali8, Saijuddin Shaikh8, Rebecca Merrill, PhD2, Lee Wu2, Keith West, DrPH, RD2, Parul Christian, PhD2 and Alain Labrique, PhD, MHS, MSc, MACE2, (1)Epidemiology and Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, (2)International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (3)Epidemiology and Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (4)Analytical Chemistry, University of Graz, Graz, Austria, (5)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (6)Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (7)Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (8)Jivita Maternal and Child Health and Nutrition Research Project, Gaibandha, Bangladesh

Disclosures:

C. Heaney, None

B. Kmush, None

A. Navas-Acien, None

K. F. Francesconi, None

K. Schulze, None

K. Nelson, None

D. Fairweather, None

S. Klein, None

H. Ali, None

S. Shaikh, None

R. Merrill, None

L. Wu, None

K. West, None

P. Christian, None

A. Labrique, None

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