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Clinical and Vaccine Immunology, March 2009, p. 312-319, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00356-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Relationship between Human Immunodeficiency Virus Type 1 Coinfection, Anemia, and Levels and Function of Antibodies to Variant Surface Antigens in Pregnancy-Associated Malaria {triangledown}

Anthony Jaworowski,1,2* Liselle A. Fernandes,1 Francisca Yosaatmadja,3 Gaoqian Feng,3 Victor Mwapasa,4 Malcolm E. Molyneux,4,5 Steven R. Meshnick,6 Jenny Lewis,7 and Stephen J. Rogerson3

Centre for Virology, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia,1 Department of Medicine, Monash University, Melbourne, Victoria, Australia,2 Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia,3 Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi,4 School of Tropical Medicine, University of Liverpool, Liverpool, United Kingdom,5 Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina,6 Centre for Epidemiology and Population Health Research, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia7

Received 24 September 2008/ Returned for modification 24 November 2008/ Accepted 24 December 2008

Human immunodeficiency virus type 1 (HIV-1) coinfection decreases antibodies to variant surface antigens implicated in pregnancy-associated malaria (VSA-PAM) caused by Plasmodium falciparum. The effect of HIV-1 on antibody functions that may protect mothers from pregnancy-associated malaria is unknown. Sera from multigravid pregnant women with malaria and HIV-1 coinfection (n = 58) or malaria alone (n = 29) and from HIV-1-infected (n = 102) or -uninfected (n = 54) multigravidae without malaria were analyzed for anti-VSA-PAM antibodies by flow cytometry, the ability to inhibit adhesion to chondroitin sulfate A, or to opsonize CS2-infected erythrocytes for phagocytosis by THP-1 cells. In women with malaria, anti-VSA-PAM levels correlated better with opsonic activity (r = 0.60) than with adhesion-blocking activity (r = 0.33). In univariate analysis, HIV-1 coinfection was associated with lower opsonic activity but not adhesion-blocking activity or anti-VSA-PAM levels. Malaria-infected women with anemia (hemoglobin levels of <11.0 g/dl) had lower opsonic activity than nonanemic women (P = 0.007) independent of HIV-1 status. By multivariate analysis, in malaria-infected women, anemia (but not HIV status) was associated with opsonic activity. In women without malaria, opsonic activity was not associated with either anemia or HIV-1 status. In multigravid pregnant women with malaria, impaired serum opsonic activity may contribute to anemia and possibly to the decreased immunity to pregnancy-associated malaria associated with HIV-1.

* Corresponding author. Mailing address: Macfarlane Burnet Institute for Medical Research and Public Health, G.P.O. Box 2284, Melbourne, Victoria 3001, Australia. Phone: 61-3-92822127. Fax: 61-3-92822100. E-mail: anthonyj{at}burnet.edu.au

{triangledown} Published ahead of print on 7 January 2009.

Clinical and Vaccine Immunology, March 2009, p. 312-319, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00356-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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