Table 2.

Mother-targeted interventions to optimize HIV-exposed infants’ health.

1.Immunization of HIV-infected pregnant women during pregnancy –Immunization of HIV-infected pregnant women with influenza vaccine: immunization with two doses of pandemic H1N1 monovalent vaccine induced similar seroprotection rates in HIV-infected pregnant women and their newborns at delivery. Seroprotection in HIV-exposed infants waned rapidly (76). Immunization with trivalent inactivated influenza vaccine (A/California/7/2009, A/Victoria/210/2009, and B/Brisbane/60/2008) induced lower seroprotection rates in HIV-infected as compared with -uninfected pregnant women, but similar vaccine efficacy (78). Lower maternal antibody transfer ratios were observed in immunized HIV-infected as compared with -uninfected women for the California and not for the two other vaccine strains (79) –Immunization of HIV-infected pregnant women with pneumococcal vaccine: immunization of pregnant women with a pneumococcal polysaccharide vaccine during the third trimester of pregnancy was associated with 46–72% antibody transfer ratios (36). Serotype-specific antibody levels waned rapidly in the HIV-exposed infants over the first 6 months of life with the estimated time to antibody levels <0.35 μg/ml for different serotypes (1, 3, 5, 6B, and 9V) ranging between 0.6 and 2.7 months (36) –Immunization of HIV-infected pregnant women with GBS vaccine: immunization with non-adjuvanted GBS capsular polysaccharide during pregnancy induced lower antibody response in HIV-infected than in -uninfected women (41). Transfer ratios were similar but antibody levels were lower in HIV-exposed as compared with unexposed newborns (41)

2.Reduction of maternal inflammation –Placental tissues from HIV-infected pregnant women on combined ARV treatment expressed lower levels of mRNA for TNF-α and IL-8 as compared with -uninfected women (82).

HIV, human immunodeficiency virus; GBS, group B Streptococcus; ARV, antiretroviral; TNF-α, tumor necrosis factor; IL, interleukin.