Dembo Edson G, Mwapasa Victor, Montgomery Jacqui, Craig Alister G, Porter Kimberly A, Meshnick Steven R, Molyneux Malcolm E, Rogerson Stephen J
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi.
Clin Vaccine Immunol. 2008 Apr;15(4):617-21. doi: 10.1128/CVI.00378-07. Epub 2008 Jan 16.
Human immunodeficiency virus (HIV) increases susceptibility to Plasmodium falciparum infection, and this has most clearly been demonstrated in pregnant women. Variant surface antigens on the surfaces of erythrocytes infected with P. falciparum are major targets of protective immunity. We studied the impact of HIV infection on pregnant women's humoral immunity to variant surface antigens expressed by placental and pediatric isolates of P. falciparum. By flow cytometry, sera from HIV-infected women more frequently lacked antibodies to these antigens than sera from HIV-uninfected women. This difference was similar in magnitude for pediatric isolates (unadjusted odds ratio [OR] = 6.36; 95% confidence interval [CI] = 1.14, 35.32; P < 0.05) and placental isolates (unadjusted OR = 6.47; 95% CI = 0.75, 55.64; P < 0.10). We divided women into high and low responders on the basis of their antibody levels. After adjustment for CD4 count, maternal age, and gravidity, we found that HIV-infected women more frequently had low responses to both pediatric isolates (OR = 5.34; 95% CI = 1.23, 23.16; P = 0.025) and placental isolates (OR = 4.14; 95% CI = 1.71, 10.02; P = 0.002). The relative quantity of antibodies to both pediatric isolates (P = 0.035) and placental isolates (P = 0.005) was lower in HIV-infected women than in HIV-uninfected women. HIV infection has a broad impact on variant-specific immunity, which may explain the susceptibility of infected individuals to clinical malaria episodes.
人类免疫缺陷病毒（HIV）会增加对恶性疟原虫感染的易感性，这一点在孕妇中表现得最为明显。感染恶性疟原虫的红细胞表面的可变表面抗原是保护性免疫的主要靶点。我们研究了HIV感染对孕妇针对胎盘和儿科来源的恶性疟原虫分离株所表达的可变表面抗原的体液免疫的影响。通过流式细胞术分析，与未感染HIV的女性血清相比，感染HIV的女性血清中更常缺乏针对这些抗原的抗体。对于儿科分离株（未调整优势比[OR]=6.36；95%置信区间[CI]=1.14, 35.32；P<0.05）和胎盘分离株（未调整OR=6.47；95%CI=0.75, 55.64；P<0.10），这种差异在程度上相似。我们根据抗体水平将女性分为高反应者和低反应者。在对CD4细胞计数、产妇年龄和妊娠次数进行调整后，我们发现感染HIV的女性对儿科分离株（OR=5.34；95%CI=1.23, 23.16；P=0.025）和胎盘分离株（OR=4.14；95%CI=1.71, 10.02；P=0.002）的低反应更为常见。感染HIV的女性针对儿科分离株（P=0.035）和胎盘分离株（P=0.005）的抗体相对量均低于未感染HIV的女性。HIV感染对变体特异性免疫有广泛影响，这可能解释了感染者易发生临床疟疾发作的原因。
