• Denise Naniche, Elisa Serra-Casas, Azucena Bardají, Llorenç Quintó, Carlota Dobaño, Betuel Sigauque, Pau Cisteró, Virander S Chauhan, Chetan E Chitnis, Pedro L Alonso, Clara Menéndez, and Alfredo Mayor.
• Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Spain.
• J. Infect. Dis. 2012 Feb 15;205(4):568-77.

BackgroundPlasmodium falciparum infection in pregnancy can lead to congenital malaria, which has detrimental health consequences for infants. Human immunodeficiency virus (HIV) might increase cord blood P. falciparum infection by decreasing maternal antimalarial-specific antibodies.MethodsHIV-negative (n=133) and HIV-positive (n=55) Mozambican pregnant women were assessed at delivery for maternal and cord P. falciparum infection by quantitative polymerase chain reaction (qPCR) and P. falciparum-specific antibodies by enzyme-linked immunosorbent assay and flow cytometry.ResultsPrevalence of qPCR-detected cord blood infection was 8.0%. Risk of cord infection was increased in presence of HIV (adjusted odds ratio [AOR], 3.80; P=.04) and placental malaria (AOR, 22.08; P=.002) after adjusting for clinical variables. The odds of having a high immunoglobulin G response to chondrotin sulphate A-binding infected erythrocytes, parasite lysate, and erythrocyte-binding antigen-175 were reduced among HIV-positive women (P < .001, .048, and .056, respectively) and among women with cord P. falciparum infection (P = .009, .04, and .046, respectively). In multivariate analysis including maternal HIV status, placental malaria, and antibody responses, HIV was no longer associated with cord blood infection (P = .11).ConclusionsHIV-associated impairment of antibody responses in pregnant women may contribute to a higher transmission of P. falciparum to their infants.

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