Nyiro, Joyce Uchi, Sande, Charles Jumba, Mutunga, Martin, Kiyuka, Patience Kerubo, Munywoki, Patrick Kioo, Scott, John Anthony G. and Nokes, D. James (2016) Absence of association between cord specific antibody levels and severe respiratory syncytial virus (RSV) disease in early infants : a case control study from coastal Kenya. PLoS One, 11 (11). e0166706. doi:10.1371/journal.pone.0166706 ISSN 1932-6203.

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Abstract

Background: The target group for severe respiratory syncytial virus (RSV) disease prevention is infants under 6 months of age. Vaccine boosting of antibody titres in pregnant mothers could protect these young infants from severe respiratory syncytial virus (RSV) associated disease. Quantifying protective levels of RSV-specific maternal antibody at birth would inform vaccine development.

Methods: A case control study nested in a birth cohort (2002–07) was conducted in Kilifi, Kenya; where 30 hospitalised cases of RSV-associated severe disease were matched to 60 controls. Participants had a cord blood and 2 subsequent 3-monthly blood samples assayed for RSV-specific neutralising antibody by the plaque reduction neutralisation test (PRNT). Two sample paired t test and conditional logistic regression were used in analyses of log2PRNT titres.

Results: The mean RSV log2PRNT titre at birth for cases and controls were not significantly different (P = 0.4) and remained so on age-stratification. Cord blood PRNT titres showed considerable overlap between cases and controls. The odds of RSV disease decreased with increase in log2PRNT cord blood titre. There was a 30% reduction in RSV disease per unit increase in log2PRNT titre (<3months age group) but not significant (P = 0.3).

Conclusions: From this study, there is no strong evidence of protection by maternal RSV specific antibodies from severe RSV disease. Cord antibody levels show wide variation with considerable overlap between cases and controls. It is likely that, there are additional factors to specific PRNT antibody levels which determine susceptibility to severe RSV disease. In addition, higher levels of neutralizing antibody beyond the normal range may be required for protection; which it is hoped can be achieved by a maternal RSV vaccine.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH):	Virus diseases, Communicable diseases, Viral vaccines
Journal or Publication Title:	PLoS One
Publisher:	Public Library of Science
ISSN:	1932-6203
Official Date:	16 November 2016
Dates:	Date Event 16 November 2016 Published 2 November 2016 Accepted 15 June 2016 Submitted
Volume:	11
Number:	11
Article Number:	e0166706
DOI:	10.1371/journal.pone.0166706
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	2 December 2016
Date of first compliant Open Access:	8 December 2016
Funder:	Program for Appropriate Technology in Health (PATH), Wellcome Trust (London, England)
Grant number:	R.LFJN.3003; 077092; 084633; 098532;

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