Abstract:
Enzyme-linked immunosorbent assays (ELISAs) are widely used to quantify
immunoglobulin levels induced by infection or vaccination. The first large-scale use of
ELISA for antibody quantitation was in diagnosis and epidemiological viral screening to
assess antibody levels after vaccination. Measles virus is transmitted through infected air
droplets. Young infants are protected from measles infection by maternal antibodies.
Maternal Human Immunodeficiency Virus (HIV) infection may reduce levels of measles
antibodies in newborns due to reduced placental transfer. Total IgG has been reported to
significantly increase in HIV infected individuals due to polyclonal activation hence
mutagenic activation. ART exposure in HIV infection causes a significant boost to
immunity of the mother which is subsequently transferred to the infant. The study was a
nested prospective cohort study within Kesho Bora Study that was conducted between
2005 – 2009 in which HIV infected pregnant women were enrolled and exposed to
different anti-retroviral drugs depending on the degree of immune suppression. This
study aimed at comparing total and anti-measles IgG levels and determining changes in
the level of IgG in HIV infected women before and after ART. The correct dilution for
Total IgG needed to be determined and the failing measles assays quality controlled
before performing the tests. Total IgG assays involved testing using the recommended
dilution factor of 1:8x104 which produced sample OD‘s 2.9-3.6 this were high and could
not be interpolated from best fit standard calibration curves. Dilution used in this study,
was1:4x105
aftermultiple dilutions and calculation of standard error that produced tight
error bars of +/-0.1 hence testing was done in singles. Cryopreserved maternal plasma
was tested for TIgG and antimeasles IgG using commercial ELISA kits before and 4
weeks after exposure to ARVs .The data was analyzed using SPSS software version
12.0. Paired t-test was used to compare the changes for IgG levels. The findings were
that in 164 HIV pregnant women the mean of TIgG was 22.7g/l before and 17.11g/l after
ART meaning there was a significant drop p-value was 0.000.7% of samples done for
antimeasles IgG tested equivocal which was significant compared to 5% negative and was 2549.94 mIU/ml before and 2412.1mIU/ml after ART, p-value was 0.001hence
there was a significant drop in the titres after ARVS administration. The findings will
give insight on effects of exposure to ART on TIgG and antimeasles IgG which will be
useful for revision of current infant measles immunization schedules on children born to
HIV seropositive mothers.