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Synergy between mannose-binding lectin gene polymorphisms and supplementation with vitamin A influences susceptibility to HIV infection in infants born to HIV-positive mothers^1,2,3

¹ From the Gertrude H Sergievsky Center, College of Physicians and Surgeons, and the Department of Epidemiology, Mailman School of Public Health, Columbia University; New York, NY (LK); the Department of Paediatrics and Child Health, Mandela School of Medicine, University of KwaZulu/Natal, Durban, South Africa (AC and DA); the Department of Immunology, University of Milano, Milano, Italy (DT and MC); the Department of Genetics, University of Trieste, Trieste, Italy (TR, LS, and SC); and the Genetic Service, Children's Hospital Burlo Garofolo, Trieste, Italy (SC).

Background: Mannose-binding lectin (MBL-2) allele variants are associated with deficiencies in innate immunity and have been found to be correlated with HIV infection in adults and children.

Objective: We tested whether MBL-2 variants among infants born to HIV-positive mothers have an increased susceptibility to HIV.

Design: MBL-2 allele variants were measured among 225 infants born to HIV-positive mothers enrolled in a trial in Durban, South Africa. Mothers of 108 infants were randomly assigned to receive vitamin A and ß-carotene supplementation and 117 to receive placebo. Infants were followed with regular HIV tests to determine rates of mother-to-child HIV transmission.

Results: A high proportion of infants were either homozygous (10.7%) or heterozygous (32.4%) for MBL-2 variants. MBL-2 variants within the placebo arm were associated with an increased risk of HIV transmission (odds ratio: 3.09; 95% CI: 1.21, 7.86); however, MBL-2 variants within the supplementation arm were not associated with an increased risk of transmission (P = 0.04; test of interaction). Among infants with MBL-2 variants, supplementation was associated with a decreased risk of HIV transmission (odds ratio: 0.37; 95% CI: 0.15, 0.91).

Conclusion: We observed what appears to be a gene-environment interaction between MBL-2 variants and an intervention with vitamin A plus ß-carotene that is relevant to mother-to-child HIV transmission.

Key Words: Mother-to-child HIV transmission • vitamin A supplementation • mannose-binding lectin • innate immunity

This article has been cited by other articles:

				S. A. Abrams and D. C. Hilmers Postnatal Vitamin A Supplementation in Developing Countries: An Intervention Whose Time Has Come? Pediatrics, July 1, 2008; 122(1): 180 - 181. [Full Text] [PDF]