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High Incidence of Group B Streptococcal Infection in Infants Born to HIV-Infected Mothers - Vol. 18 No. 3 - March 2012 - Emerging Infectious Disease journal - CDC

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Volume 18, Number 3–March 2012



High Incidence of Group B Streptococcal Infection in Infants Born to HIV-Infected Mothers - Vol. 18 No. 3 - March 2012 - Emerging Infectious Disease journal - CDC


Volume 18, Number 3—March 2012

Letter

High Incidence of Group B Streptococcal Infection in Infants Born to HIV-Infected Mothers

Suggested citation for this article
To the Editor: In their cross-sectional study comparing group B streptococcus (GBS) carriage among HIV-infected and HIV-uninfected women in Malawi, Gray et al. found no differences in GBS carriage between both groups but found a higher carriage rate for HIV-infected women with high CD4 cell counts (1). They proposed that a GBS-specific immune defect might exist in HIV-infected pregnant women and suggested that this defect could be blurred by competitive exclusion of GBS as a consequence of changes in microbial flora at lower CD4 counts.
We recently reported an increased incidence of neonatal GBS sepsis in HIV-exposed uninfected (HEU) infants born in Belgium, compared with the general population (2). In our cohort, the risk for GBS infection was 20× higher in HEU infants than in infants born to HIV-uninfected mothers. Moreover, the episodes of GBS sepsis in HEU infants, compared with the general population, were more severe and mostly of late onset. We are currently looking prospectively at GBS carriage in HIV-infected and control uninfected pregnant women to learn whether our observation can be explained by a higher carriage rate in HIV-infected women or by increased susceptibility of HEU infants to this capsulated bacteria. The latter hypothesis would be in line with the higher susceptibility of HEU children to other types of severe infections, as has been described in several studies from sub-Saharan Africa and Latin America (35).
The incidence of GBS sepsis in HIV-exposed infants born in Africa is unknown. In addition to the need for further investigation of anti-GBS immunity in HIV-infected pregnant women, we believe that studies comparing the incidence of neonatal GBS sepsis in HEU and HIV-unexposed infants are warranted. If the increased risk for GBS sepsis is confirmed, prophylaxis should be implemented in the population concerned.
Tessa GoetghebuerComments to Author , Catherine Adler, Cristina Epalza, and Jack Levy
Author affiliations: Saint-Pierre University Hospital, Brussels, Belgium

References

  1. Gray  KJ, Kafulafula  G, Matemba  M, Kamdolozi  M, Membe  G, French  N, Streptococcus and HIV infection in pregnant women, Malawi, 2008–2010. Emerg Infect Dis. 2011;17:19325.PubMedExternal Web Site Icon
  2. Epalza  C, Goetghebuer  T, Hainaut  M, Prayez  F, Barlow  P, Dediste  A, High incidence of invasive group B streptococcal infections in HIV-exposed uninfected infants. Pediatrics. 2010;126:e6318. DOIExternal Web Site IconPubMedExternal Web Site Icon
  3. Mussi-Pinhata  MM, Freimanis  L, Yamamoto  AY, Korelitz  J, Pinto  JA, Cruz  ML, Infectious disease morbidity among young HIV-1–exposed but uninfected infants in Latin American and Caribbean countries: the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study. Pediatrics. 2007;119:e694704. DOIExternal Web Site IconPubMedExternal Web Site Icon
  4. Koyanagi  A, Humphrey  JH, Ntozini  R, Nathoo  K, Moulton  LH, Iliff  P, Morbidity among human immunodeficiency virus–exposed but uninfected, human immunodeficiency virus–infected, and human immunodeficiency virus–unexposed infants in Zimbabwe before availability of highly active antiretroviral therapy. Pediatr Infect Dis J. 2011;30:4551. DOIExternal Web Site IconPubMedExternal Web Site Icon
  5. Filteau  S. The HIV-exposed, uninfected African child. Trop Med Int Health. 2009;14:27687. DOIExternal Web Site IconPubMedExternal Web Site Icon
Suggested citation for this article: Goetghebuer T, Adler C, Epalza C, Levy J. High incidence of group B streptococcal infection in infants born to HIV-infected mothers [letter]. Emerg Infect Dis [serial on the Internet] 2012 Mar [date cited]. http://dx.doi.org/10.3201/eid1803.111630External Web Site Icon
DOI: 10.3201/eid1803.111630

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