Effects of maternal HIV infection on early Kaposi's sarcoma-associated herpesvirus (KSHV) seroconversion in a Kenyan mother-infant cohort

We identified whether maternal HIV infection during pregnancy affects transplacental transfer of Kaposi's sarcoma-associated herpesvirus (KSHV) specific antibodies and subsequent infant infection. We followed pregnant Kenyan women through delivery and their infants until age two years. Children were classified as HIV-exposed uninfected (HEU) or HIV-unexposed uninfected (HUU) based on maternal HIV status. Maternal venous and cord blood at delivery and child venous blood every six months were tested for antibodies to 20 KSHV antigens by multiplex bead-based immunoassay. Multiple comparisons were adjusted using false discovery rate (FDR). Maternal HIV infection was significantly associated with decreased transplacental transfer of antibodies against all KSHV antigens and lower cord blood levels for eight antigens at FDR p< 0.10. Neither birth to six-month antibody level changes nor six-month levels differed in HEU and HUU, except for ORF50. 74% of children KSHV seroconverted by age 24 months but HEU and HUU did not differ in time to seroconversion nor two-year seropositivity after adjustment for child malaria infection. Maternal HIV infection reduced a child's initial KSHV antibody levels but did not affect age of infection. Regardless of HIV exposure in utero, KSHV seroconversion in Kenyan children occurred early; associated factors must be identified. © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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