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Emerging data point to altered antibody transfer in women with HIV (WHIV); however, specific perturbations and the influence of antiretroviral therapy (ART) and HIV viremia remain unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We evaluated antigen-specific transplacental antibody transfer across 14 antigens in paired maternal and umbilical cord plasma from 352 Ugandan women; 176 were WHIV taking ART. We measured antigen-specific immunoglobulin G (IgG) sub\u00adclass (IgG1, 2, 3, 4) levels and antibody Fc\u03b3 receptor (Fc\u03b3Rn, 2a, 2b, 3a, 3b) binding profiles. We used partial least squares discrimi\u00adnant analysis to define antigen-specific transplacental antibody transfer features.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Global antibody transfer patterns were similar by maternal HIV serostatus, pointing to effective placental function in WHIV. However, HEU umbilical cord antibody profiles were altered, driven by perturbed WHIV seroprofiles, with higher levels of herpesvirus antibodies (P &amp;lt; .01 for Epstein-Barr virus, herpes simplex virus) and lower levels of classic vaccine-induced antibodies (P &amp;lt; .01 for tetanus, polio, Haemophilus influenzae type b), suggesting that umbilical cord antibody profile differences arise from imbalanced WHIV immunity. Abnormal WHIV antibody profiles were associated with HIV viremia, lower CD4 count, and postconception ART initiation (P = .01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Perturbed immune-dominance profiles in WHIV shift the balance of immunity delivered to neonates. Perturbed HIV-associated maternal antibody profiles are a key determinant of com\u00adpromised neonatal immunity. Maternal vaccination interventions may promote transfer of relevant, effective antibodies to protect HEU children against early-life infections.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac156","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T12:20:40Z","timestamp":1646310040000},"page":"1359-1369","source":"Crossref","is-referenced-by-count":20,"title":["Altered Maternal Antibody Profiles in Women With Human Immunodeficiency Virus Drive Changes in Transplacental Antibody Transfer"],"prefix":"10.1093","volume":"75","author":[{"given":"Sepideh","family":"Dolatshahi","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, University of Virginia , Charlottesville, Virginia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey L","family":"Butler","sequence":"additional","affiliation":[{"name":"State University of New York Upstate Medical University , Syracuse, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J","family":"Siedner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Center for Global Health, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ngonzi","sequence":"additional","affiliation":[{"name":"Mbarara University of Science and Technology , Mbarara , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea G","family":"Edlow","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Adong","sequence":"additional","affiliation":[{"name":"Mbarara University of Science and Technology , Mbarara , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine F","family":"Jennewein","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center , Seattle, Washington , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Atyeo","sequence":"additional","affiliation":[{"name":"Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard , Cambridge, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid V","family":"Bassett","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drucilla J","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Pathology, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas A","family":"Lauffenburger","sequence":"additional","affiliation":[{"name":"Massachusetts Institute of Technology , Cambridge, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-9215","authenticated-orcid":false,"given":"Galit","family":"Alter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard , Cambridge, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0077-6522","authenticated-orcid":false,"given":"Lisa M","family":"Bebell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Center for Global Health, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"2022101219185165000_CIT0001","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1097\/INF.0000000000000489","article-title":"Infections in HIV-exposed uninfected children with focus on sub-Saharan Africa.","volume":"33","author":"Cotton","year":"2014","journal-title":"Pediatr Infect Dis 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