Over 35% of children in a region of
malaria endemicity are infected with Epstein-Barr virus (EBV) by 6 months of age. This susceptibility may be linked to impaired transplacental transfer of
antibodies. In this study, we determined the effect of
malaria exposure during pregnancy on the transfer of EBV-specific maternal
antibodies in a region of western Kenya that experiences endemic
malaria. Pregnant mothers were recruited and followed up until delivery to determine levels of neonatal
malaria exposure. Levels of EBV lytic (viral capsid
antigen [VCA], Z transcriptional activator [Zta], and early diffuse
antigen complex [EAd]) and EBV latent (
EBV nuclear antigen-1 (EBNA1]) and
tetanus-specific
IgG antibodies were measured in 70 paired maternal and cord blood samples using a Luminex-bead-based assay. A high proportion (63%) of the infants were exposed to
malaria in utero. Levels of EBV- and
tetanus-specific
antibodies were similar in
malaria-infected mothers and in mothers who had no detectable
malaria infection.
Malaria-exposed neonates had significantly lower levels of anti-EBNA1, anti-Zta, and anti-EAd
antibodies than were seen in their mothers. In utero
malaria exposure resulted in significant reductions in transplacental transfer of anti-VCA-p18 and anti-EBNA1
antibodies of 13% and 22%, respectively. Neonates received significantly low levels of anti-Zta and anti-EAd
antibodies irrespective of
malaria exposure levels. In multivariate analysis, in utero
malaria exposure was associated with a significant reduction in the transfer of anti-VCA-p18 and anti-EBNA1
antibodies to the neonates (P = 0.0234 and P = 0.0017, respectively).
Malaria during pregnancy results in differential levels of transfer of EBV-specific
antibodies from the mother to the fetus. The impaired transplacental transfer of some
antibodies may lead to the
malaria-exposed neonates being susceptible to early
EBV infection.