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A Mother-to-Child Transmission Study in Nigeria: The Impact of Maternal HIV Infection and HAART on Plasma Immunoglobulins, Cytokine Profiles and Infant Outcome


Prevention of mother-to-child transmission (PMTCT) of HIV with highly active antiretroviral therapy (HARRT) allows the HIV+ pregnant mothers to have vaginal delivery and breastfeed. Here we investigated the maternal plasma immunoglobulin, cytokine secretion and the outcome of the exposed infants among the HIV+ HAART treated pregnant women in Nigeria. In this study, different plasma immunoglobulins and cytokines were measured in the HIV+ HAART treated pregnant mothers. Pooled culture supernatants of B and T lymphocytes showed lower levels of IFN-γ, IL-10 and IL-4. There were lower IFN-γ and IL-10 secretions at 1st trimester; however, IL-10 continued to be lower throughout 2nd and 3rd trimesters. TNF-α secretion significantly decreased as pregnancy progressed to term. There were high plasma IgG and low IgM in the HIV+ HAART treated pregnant women. Plasma IgG was high during 1st and 3rd trimesters. After one year of follow up, all the exposed children were seronegative for HIV-1 and HIV-2. Vaginal delivery and breastfeeding among HIV+ HAART treated mothers have shown to be safe. The use of HAART by the infected mothers and the use of septrin and niverapin by the exposed infants prevented mother to-child transmission of HIV.

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This work was partly supported by TETFUND Nigeria through Ebonyi State University (EBSU) Abakaliki. We thank Prof. EO Ekumankama, former DVC of EBSU for his effort to see that grants were secured to complete the study in the United States of America.

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Authors and Affiliations



COE-A and CCO did conception and design of the work. COE-A interviewed the patients and collected samples. COE-A and OU did sample shipment. COE-A and LR analyzed samples. COE-A and PM did follow-up on the exposed infants. COE-A, LR and CCO interpreted the patient data. COE-A, LR and CCO were a major contributor in writing the manuscript. COE-A, LR checked and finalized the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Chinwe O. Ewenighi-Amankwah or Lijun Rong.

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The authors declare that they have no conflict of interest.

Animal and Human Rights Statement

Additional informed consent was obtained from all patients for which identifying information is included in this article. Ethical clearance was obtained from the Ethical Committee of the Department of Medical Laboratory Science, Faculty of Health Science, Nnamdi Azikiwe University, Nnewi Nigeria. Ethical approval letter to see the subjects was obtained from ethical committee of Mother of Christ Specialist, Hospital, Ogui Enugu, Nigeria. The aim of the research was explained to all the HIV+ HAART treated pregnant women and the control pregnant women seen at the PMTCT clinic and antenatal clinics of Mother of Christ Specialist, Hospital, Ogui Enugu, Nigeria. All the subjects were allowed to participate willingly and withdrawal at any time was allowed. All subjects filled a questionnaire and signed a consent form before blood samples were collected. Procedures followed were in accordance with the ethical standards of the Helsinki Declaration (1964, amended most recently in 2008), which was created by the World Medical Association. Ethical clearance letters are attached.

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Ewenighi-Amankwah, C.O., Onyenekwe, C.C., Udemba, O. et al. A Mother-to-Child Transmission Study in Nigeria: The Impact of Maternal HIV Infection and HAART on Plasma Immunoglobulins, Cytokine Profiles and Infant Outcome. Virol. Sin. 35, 468–477 (2020).

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  • Human immunodeficiency virus (HIV)
  • Prevention from mother-to-child transmission (PMTCT)
  • Highly active antiretroviral therapy (HAART)
  • Lymphocyte stimulation
  • Mitogen
  • Cytokine
  • Immunoglobulins