The impact of maternal soluble human leukocyte Antigen-G levels on risk to malaria in infants at Masafu, Busia, Uganda

Abstract

Background: HLA-G is known to play a vital role in protection of the fetus in utero against maternal natural killer cells, but it is associated with progression of both viral and parasitic infection such as Plasmodium falciparum (Pf) infection. Previous studies conducted in Benin have demonstrated a strong correlation between high levels of maternal soluble HLA-G (sHLA-G) and increased incidences of malaria in infants’ first years of life. Majority of studies were done in the same population despite genetic diversity. There is limited data on the impact of DP versus SP on maternal sHLA-G levels, thus its effect on malaria during pregnancy is understudied. This study aimed to determine and compare the effect of DP vs SP on maternal, cord blood sHLA-G levels, and associated risk to malaria in the infant’s first years of life. Method: The study was cross sectional and longitudinal, nested in a double blinded randomized clinical trial, which was carried out in Masafu, Busia Uganda. A total of 255 maternal/cord plasma pairs, obtained from mothers initially randomized to IPTP SP and DP were used to measure sHLA-G levels using sandwich ELISA. Data for malaria (Pf) in the infant during 1 year of follow-up was obtained from mother study. Results: Maternal and cord sHLA-G levels were not correlated (P= 0.2668), there was no significant difference between maternal sHLA-G levels in the SP and DP treatment arms (P= 0.9573). However, there was a trend in cord blood sHLA-G levels SP arm was higher than DP treatment arms although not significant (P= 0.4073). There was no significant association between the maternal, cord sHLA-G levels with first malaria episode and malaria incidence. Conclusion: There was no correlation between maternal and cord blood sHlA-G levels at birth. The maternal HLA-G levels in both the SP and DP treatment arms where not significantly different. There was a trend in cord HLA-G levels where the SP arm was higher the DP arm but not significant. Both maternal and cord sHLA-G levels in the SP and DP treatment arms were not associated with infant’s risk to malaria in first year of life.