Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.

Despite considerable reduction of mother-to-child transmission (MTCT) of HIV through use of maternal and infant antiretroviral therapy (ART), over 150,000 infants continue to become infected with HIV annually, falling far short of the World Health Organization goal of reaching <20,000 annual pedi...

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Main Authors: Amit Kumar, Elena E Giorgi, Joshua J Tu, David R Martinez, Joshua Eudailey, Michael Mengual, Manukumar Honnayakanahalli Marichannegowda, Russell Van Dyke, Feng Gao, Sallie R Permar
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-04-01
Series:PLoS Pathogens
Online Access:https://doi.org/10.1371/journal.ppat.1009478
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author Amit Kumar
Elena E Giorgi
Joshua J Tu
David R Martinez
Joshua Eudailey
Michael Mengual
Manukumar Honnayakanahalli Marichannegowda
Russell Van Dyke
Feng Gao
Sallie R Permar
author_facet Amit Kumar
Elena E Giorgi
Joshua J Tu
David R Martinez
Joshua Eudailey
Michael Mengual
Manukumar Honnayakanahalli Marichannegowda
Russell Van Dyke
Feng Gao
Sallie R Permar
author_sort Amit Kumar
collection DOAJ
description Despite considerable reduction of mother-to-child transmission (MTCT) of HIV through use of maternal and infant antiretroviral therapy (ART), over 150,000 infants continue to become infected with HIV annually, falling far short of the World Health Organization goal of reaching <20,000 annual pediatric HIV cases worldwide by 2020. Prior to the widespread use of ART in the setting of pregnancy, over half of infants born to HIV-infected mothers were protected against HIV acquisition. Yet, the role of maternal immune factors in this protection against vertical transmission is still unclear, hampering the development of synergistic strategies to further reduce MTCT. It has been established that infant transmitted/founder (T/F) viruses are often resistant to maternal plasma, yet it is unknown if the neutralization resistance profile of circulating viruses predicts the maternal risk of transmission to her infant. In this study, we amplified HIV-1 envelope genes (env) by single genome amplification and produced representative Env variants from plasma of 19 non-transmitting mothers from the U.S. Women Infant Transmission Study (WITS), enrolled in the pre-ART era. Maternal HIV Env variants from non-transmitting mothers had similar sensitivity to autologous plasma as observed for non-transmitting variants from transmitting mothers. In contrast, infant variants were on average 30% less sensitive to paired plasma neutralization compared to non-transmitted maternal variants from both transmitting and non-transmitting mothers (p = 0.015). Importantly, a signature sequence analysis revealed that motifs enriched in env sequences from transmitting mothers were associated with broadly neutralizing antibody (bnAb) resistance. Altogether, our findings suggest that circulating maternal virus resistance to bnAb-mediated neutralization, but not autologous plasma neutralization, near the time of delivery, predicts increased MTCT risk. These results caution that enhancement of maternal plasma neutralization through passive or active vaccination during pregnancy may potentially drive the evolution of variants fit for vertical transmission.
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spelling doaj.art-9175324066cc4e44ade847ce15b4fe632022-12-22T02:12:24ZengPublic Library of Science (PLoS)PLoS Pathogens1553-73661553-73742021-04-01174e100947810.1371/journal.ppat.1009478Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.Amit KumarElena E GiorgiJoshua J TuDavid R MartinezJoshua EudaileyMichael MengualManukumar Honnayakanahalli MarichannegowdaRussell Van DykeFeng GaoSallie R PermarDespite considerable reduction of mother-to-child transmission (MTCT) of HIV through use of maternal and infant antiretroviral therapy (ART), over 150,000 infants continue to become infected with HIV annually, falling far short of the World Health Organization goal of reaching <20,000 annual pediatric HIV cases worldwide by 2020. Prior to the widespread use of ART in the setting of pregnancy, over half of infants born to HIV-infected mothers were protected against HIV acquisition. Yet, the role of maternal immune factors in this protection against vertical transmission is still unclear, hampering the development of synergistic strategies to further reduce MTCT. It has been established that infant transmitted/founder (T/F) viruses are often resistant to maternal plasma, yet it is unknown if the neutralization resistance profile of circulating viruses predicts the maternal risk of transmission to her infant. In this study, we amplified HIV-1 envelope genes (env) by single genome amplification and produced representative Env variants from plasma of 19 non-transmitting mothers from the U.S. Women Infant Transmission Study (WITS), enrolled in the pre-ART era. Maternal HIV Env variants from non-transmitting mothers had similar sensitivity to autologous plasma as observed for non-transmitting variants from transmitting mothers. In contrast, infant variants were on average 30% less sensitive to paired plasma neutralization compared to non-transmitted maternal variants from both transmitting and non-transmitting mothers (p = 0.015). Importantly, a signature sequence analysis revealed that motifs enriched in env sequences from transmitting mothers were associated with broadly neutralizing antibody (bnAb) resistance. Altogether, our findings suggest that circulating maternal virus resistance to bnAb-mediated neutralization, but not autologous plasma neutralization, near the time of delivery, predicts increased MTCT risk. These results caution that enhancement of maternal plasma neutralization through passive or active vaccination during pregnancy may potentially drive the evolution of variants fit for vertical transmission.https://doi.org/10.1371/journal.ppat.1009478
spellingShingle Amit Kumar
Elena E Giorgi
Joshua J Tu
David R Martinez
Joshua Eudailey
Michael Mengual
Manukumar Honnayakanahalli Marichannegowda
Russell Van Dyke
Feng Gao
Sallie R Permar
Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
PLoS Pathogens
title Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
title_full Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
title_fullStr Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
title_full_unstemmed Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
title_short Mutations that confer resistance to broadly-neutralizing antibodies define HIV-1 variants of transmitting mothers from that of non-transmitting mothers.
title_sort mutations that confer resistance to broadly neutralizing antibodies define hiv 1 variants of transmitting mothers from that of non transmitting mothers
url https://doi.org/10.1371/journal.ppat.1009478
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