Increased risk of group B streptococcal sepsis and meningitis in HIV-exposed uninfected infants in a high-income country

Manzanares, Ángela; Prieto-Tato, Luis; Escosa-García, Luis; Navarro, Ma Luisa; Guillén, Sara; Penin, María; Hernanz-Lobo, Alicia; Soto-Sánchez, Beatriz; Beceiro-Mosquera, J.; Falces‐Romero, Iker; Ramos-Amador, José Tomás; Orellana-Miguel, M Á; Epalza, Cristina

doi:10.1007/s00431-022-04710-6

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Of note, incidence of GBS sepsis is higher in sub-Saharan Africa, where HIV prevalence is the highest. Different studies both in HIC and LMIC have found an increased risk of both EOD and LOD in HEU infants [23,24]. Systematic screening for GBS in late pregnancy and antibiotic prophylaxis during labour decreases significantly EOD incidence but has no impact on LOD [70].…”

Section: Upcoming Vaccine: Maternal Group B Streptococcus Vaccinationmentioning

confidence: 98%

“…In the following decades, different epidemiological studies in Europe, Sub-Saharan Africa and North and South-America have reported an increased susceptibility to severe infectious diseases in HEU infants (reviewed in [9,12]). This infectious risk concerned bacterial infections such group B streptococcus (both early-onset and lateonset sepsis) [21][22][23][24], Streptococcus pneumoniae [11,22], B. pertussis [25] and viral infections, mostly respiratory infections caused by RSV [10,[26][27][28] or influenza [26] and even Pneumocystis jiroveci carriage [29]. The heterogeneity of pathogens involved in this increased infectious risk likely reflect alteration in different immune pathways [30].…”

Section: Infectious Risk Of Hiv-exposed But Uninfected Infantsmentioning

confidence: 99%

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Maternal immunization in women living with HIV

Dauby,

Gagneux-Brunon,

Martin

et al. 2023

Aids

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Thanks to widespread use of antiretroviral therapy worldwide, women living with HIV (WLWH) are becoming pregnant and giving birth to HIV-exposed but uninfected (HEU) newborns. Both pregnancy and HIV infection-related factors such as low CD4+ T-cell count or uncontrolled viral load increase the risk of severe infections such as influenza, COVID-19, and others, making maternal immunization a valuable tool to decrease maternal morbidity among WLWH. Vaccines administered during pregnancy may also benefit the health of HEU infants. Indeed, HEU infants suffer from higher risk of morbidity of infectious origin, including respiratory syncytial virus (RSV), group B streptococcus (GBS), pneumococcus and pertussis infections. Maternal pertussis immunization is recommended in various high-income countries but not in many low-middle income countries where HIV prevalence is higher. GBS and RSV vaccines to be administered during pregnancy are currently in late-phase clinical trials in HIV-uninfected women and could represent a valuable tool to decrease morbidity during infancy. Decreased transfer of vaccine-specific IgG, accelerated waning of vaccine-induced antibody responses, linked to persistent maternal immune activation, and blunting of infant immune response to vaccines could hamper vaccine effectiveness among WLWH and HEU infants. Vaccine hesitancy could limit benefits of maternal immunization and strategies to tackle vaccine hesitancy should be part of HIV routine care. The aim of this review is to summarize the current knowledge regarding the immunogenicity and efficacy of available and upcoming vaccines recommended during pregnancy of WLWH.

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Section: Upcoming Vaccine: Maternal Group B Streptococcus Vaccinationmentioning

confidence: 98%

Section: Infectious Risk Of Hiv-exposed But Uninfected Infantsmentioning

confidence: 99%

Maternal immunization in women living with HIV

Dauby,

Gagneux-Brunon,

Martin

et al. 2023

Aids

View full text Add to dashboard Cite

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“…The main causes of early-onset neonatal infection are vertical transmission from the mother and GBS infection of the amniotic membranes. Over 95% of early-onset infections are related to GBS serotypes Ia, Ib, II, III, IV, and V. Among newborns with early-onset infection, 80%–85% will develop sepsis ( Simonsen et al, 2014 ), 10% will develop pneumonia ( Finsterer, 2022 ), and 5%–10% will develop meningitis ( Manzanares et al, 2023 ). Meningitis is a late-onset disease that occurs between 6 days and more than 90 days after birth.…”

Section: Gbs Related Clinical Diseases In Obstetrics and Gynecologymentioning

confidence: 99%

Current research update on group B streptococcal infection related to obstetrics and gynecology

Liu,

2024

Front. Pharmacol.

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Group B streptococcal (GBS) is a Gram-positive bacterium that is commonly found in the gastrointestinal tract and urogenital tract. GBS infestation during pregnancy is a significant contributor to maternal and neonatal morbidity and mortality globally. This article aims to discuss the infectious diseases caused by GBS in the field of obstetrics and gynecology, as well as the challenges associated with the detection, treatment, and prevention of GBS.

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“…In South Africa, the antenatal HIV prevalence rate has remained at 30% over the last two decades ( 89 ). Despite advancements in the prevention of mother to child programmes of HIV, HIV-infected pregnant women have an increased risk of having a baby with invasive GBS disease ( 90 , 91 ). HIV-exposed neonates have lower serotype-specific and surface protein antibody levels at birth compared to HIV-unexposed neonates ( 92 , 93 ).…”

Section: Maternal Gbs Vaccinationmentioning

confidence: 99%

Early-onset group B streptococcal disease in African countries and maternal vaccination strategies

Dangor

Seale

Baba

et al. 2023

Front. Public Health

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Invasive group B streptococcal (GBS) disease is the commonest perinatally-acquired bacterial infection in newborns; the burden is higher in African countries where intrapartum antibiotic prophylaxis strategies are not feasible. In sub-Saharan Africa, almost one in four newborns with GBS early-onset disease will demise, and one in ten survivors have moderate or severe neurodevelopmental impairment. A maternal GBS vaccine to prevent invasive GBS disease in infancy is a pragmatic and cost-effective preventative strategy for Africa. Hexavalent polysaccharide protein conjugate and Alpha family surface protein vaccines are undergoing phase II clinical trials. Vaccine licensure may be facilitated by demonstrating safety and immunological correlates/thresholds suggestive of protection against invasive GBS disease. This will then be followed by phase IV effectiveness studies to assess the burden of GBS vaccine preventable disease, including the effect on all-cause neonatal infections, neonatal deaths and stillbirths.

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Increased risk of group B streptococcal sepsis and meningitis in HIV-exposed uninfected infants in a high-income country

Cited by 3 publications

References 11 publications

Maternal immunization in women living with HIV

Maternal immunization in women living with HIV

Current research update on group B streptococcal infection related to obstetrics and gynecology

Early-onset group B streptococcal disease in African countries and maternal vaccination strategies

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