Comparison of hepatitis E virus genotypes from rabbits and pigs in the same geographic area: No evidence of natural cross-species transmission between the two animals

Domesticated pigs have been shown to be a reservoir of genotypes 3 and 4 hepatitis E virus (HEV). Farmed rabbits were recently recognized as the host of a novel virus, rabbit HEV. In order to determine whether HEV is transmitted naturally between rabbits and pigs, a survey on HEV infections was conducted in rabbits and pigs aged 2–4 months from rabbit and pig farms located near to each other in nine villages in three counties of Hebei Province, China. The overall anti-HEV antibody positivity rates in serum samples of swine and rabbits were 61.7% (58/94) and 23.2% (67/289), and the positive rates for HEV RNA were 23.4% (22/94) and 10% (29/289), respectively. In addition, 37 of 125 swine fecal samples (29.6%) were HEV RNA positive. The nucleotide sequences of a 304 bp region within HEV ORF2 have identity ranging from 84.5% to 100% among the rabbit isolates and from 82.3% to 100% among the swine isolates. In contrast, the nucleotide identity between the two species groups was only 72–76.6%. Consequently, the two groups were clearly separated in the phylogenetic tree that showed all of the rabbit isolates are closely related to the rabbit HEV reported recently and the swine isolates belong to genotype 4, including subgenotypes 4a, 4c and 4d. The results showed that HEV is highly prevalent in farmed rabbits and pigs in these areas. However, genotype 4 HEV and rabbit HEV are circulating separately in pigs and rabbits in the same area. In conclusion, there was no evidence of cross-species transmission of HEV between pigs and rabbits. The frequency of HEV transmission events between these two animal species is likely low in commercial farms.     

Antigenic composition and immunoreactivity differences between HEV recombinant capsid proteins generated from different genotypes

Appreciable variability has been observed in hepatitis E virus (HEV) serological diagnostics. Four recombinant proteins (p166s) were generated from position 452 to 617 aa of ORF2 of different HEV genotypes and used in an indirect ELISA to detect anti-HEV IgMs and IgGs in serially diluted sera of patients infected with different HEV genotypes (genotype 1, n = 15; genotype 3, n = 12; genotype 4, n = 17). To evaluate the differences at a conformational level, 3D-structure models of p166s were predicted, and different bioinformatics tools were used to analyze the antigenic composition. With both anti-HEV IgMs and IgGs antibodies, there was a considerable variability between the four antigens immunoreactivities. In silico results revealed the region 483–533 aa with the highest antigenic potential and contains six key aa at positions 488, 489, 512, 533, 483 and 530. This immunoreactivity variation could affect diagnosis results and seroprevalence estimations and the identification in silico of a region highly antigenic would guide the development of efficient serological assays and epitope-based vaccines.     

Specific memory B cell response and participation of CD4+ central and effector memory T cells in mice immunized with liposome encapsulated recombinant NE protein based Hepatitis E vaccine candidate

BackgroundLiposome encapsulated neutralizing epitope protein of Hepatitis E virus (HEV), rNEp, our Hepatitis E vaccine candidate, was shown to be immunogenic and safe in pregnant and non-pregnant mice and yielded sterilizing immunity in rhesus monkeys.MethodsThe current study in Balb/c mice assessed the levels and persistence of anti-HEV IgG antibodies by ELISA, frequencies of B, memory B, T and memory T cells by flow cytometry and HEV-specific IgG secreting memory B cells by ELISPOT till 420 days post immunization (PI) with 5 μg rNEp encapsulated in liposome based adjuvant (2 doses, 4 weeks apart). Mice immunized with a lower dose (1 μg) were assessed only for anamnestic response post booster dose.ResultsVaccine candidate immunized mice (5 μg dose) elicited strong anti-HEV IgG response that was estimated to persist for lifetime. At day 120 PI, frequency of memory B cells was higher in immunized mice than those receiving adjuvant alone. Anti-HEV IgG titers were lower in mice immunized with 1 μg dose. A booster dose yielded a heightened antibody response in mice with both high (>800 GMT, 5 μg) and low (⩽100 GMT, 1 μg) anti-HEV IgG titers. At day 6th post booster dose, HEV-specific antibody secreting plasma cells (ASCs) were detected in 100% and 50% of mice with high and low anti-HEV IgG titers, respectively, whereas the frequencies of CD4⁺ central and effector memory T cells were high in mice with high anti-HEV IgG titers only.ConclusionsTaken together, the vaccine candidate effectively generates persistent and anamnestic antibody response, elicits participation of CD4⁺ memory T cells and triggers memory B cells to differentiate into ASCs upon boosting. This approach of assessing the immunogenicity of vaccine candidate could be useful to explore the longevity of HEV-specific memory response in future HEV vaccine trials in human.     

Detection of IgM and IgG against hepatitis E virus in serum and meat juice samples from pigs at slaughter in Bavaria, Germany

Hepatitis E virus (HEV) is an emerging foodborne pathogen with domestic and wild pigs (and likely other species such as deer or rabbits) recognized as reservoir. Pathogenesis in pigs usually leads to an asymptomatic course of disease. Since there is no enzyme-linked immunosorbent assay (ELISA) kit for the detection of anti-HEV antibodies in pigs commercially available, the objective of this study was to assess the seroprevalence in fattening pigs at slaughter and at herd level using a newly developed ELISA based on genotype (GT) 1 and GT 3 in Bavaria, Germany. Based on 516 serum and 198 meat juice samples collected from different herds at four different Bavarian slaughterhouses, the overall seroprevalence of anti-HEV IgG in serum and meat juice samples was 68.6% and 67.6%, respectively. Analyzing the serum for the presence of anti-HEV IgM, 36/516 (7%) were positive for anti-HEV IgM. At herd level, most of the herds were seropositive for anti-HEV antibodies. The present study shows that HEV is widespread among the Bavarian pig population and that some pigs might test positive for anti-HEV IgM even at the age of slaughter. Also, meat juice serves as an equivalent matrix to serum to test for anti-HEV antibodies in pigs.     

Bayesian estimation of hepatitis E virus seroprevalence for populations with different exposure levels to swine in The Netherlands

Hepatitis E virus (HEV) is ubiquitous in pigs worldwide and may be zoonotic. Previous HEV seroprevalence estimates for groups of people working with swine were higher than for control groups. However, discordance among results of anti-HEV assays means that true seroprevalence estimates, i.e. seroprevalence due to previous exposure to HEV, depends on choice of seroassay. We tested blood samples from three subpopulations (49 swine veterinarians, 153 non-swine veterinarians and 644 randomly selected individuals from the general population) with one IgM and two IgG ELISAs, and subsets with IgG and/or IgM Western blots. A Bayesian stochastical model was used to combine results of all assays. The model accounted for imperfection of each assay by estimating sensitivity and specificity, and accounted for dependence between serological assays. As expected, discordance among assay results occurred. Applying the model yielded seroprevalence estimates of approximately 11% for swine veterinarians,approximately 6% for non-swine veterinarians and approximately 2% for the general population. By combining the results of five serological assays in a Bayesian stochastical model we confirmed that exposure to swine or their environment was associated with elevated HEV seroprevalence.     

Modeling the long-term antibody response of a hepatitis E vaccine

BackgroundThe first commercialized hepatitis E vaccine, HEV 239, has been shown to be safe and highly immunogenic, the protection as well as the vaccine-induced anti-HEV maintained for at least 4.5 years. However, the longer term persistence of the vaccine-induced anti-HEV responses is unknown.MethodsTwo statistical models, the power-law model and the modified power-law model, were applied to predict the long-term antibody response of the HEV 239 vaccine. The models were fit using the anti-HEV IgG data from a modeling subpopulation of 1278 baseline seronegative vaccinees who seroconverted within one month after finishing the whole vaccination course in the phase 3 trial of HEV 239. In addition, antibody data from a validation subpopulation were used to validate the robustness of the derived models.ResultsIn the vaccinees without pre-vaccination immunity, the power-law model and the modified power-law model estimated that the median duration of the detectable antibody (≥0.077 WU/ml) was 8 years and 13 years, respectively. The power-law model and the modified power-law model estimated that 50% of these vaccinees will maintain detectable levels of anti-HEV IgG for 8 years and >30 years, respectively.ConclusionsThe recombinant hepatitis E vaccine HEV 239 is predicted to provide from 8 years to nearly life-long persistence of anti-HEV IgG above detectable levels. Model predictions are based on conservative mathematical assumptions.(NCT01014845).     

Phylogenetic analysis of Hepatitis E virus strains isolated from slaughter-age pigs in Colombia

Hepatitis E virus (HEV) is a zoonotic virus that causes acute hepatitis in humans, and can be transmitted via the fecal–oral route. Pigs are considered to be a reservoir for this infection—mainly where the disease is not endemic. In a previous study conducted in Antioquia, which is a region in Colombia where the production and consumption of pork meat is higher than in the rest of the country, the presence of anti-HEV IgG-type antibodies was reported in slaughter-age pigs. Aiming to identify the HEV genotype circulating in swine, animal liver, and feces samples from five swine cattle slaughterhouses located in six different sub-regions of Antioquia were collected. A nested RT-PCR (nRT-PCR) was used in order to amplify the HEV ORF-1 (170 bp) and ORF-2 (348, and 958 bp). The amplicons yielded in this study were sequenced, and a molecular phylogeny analysis based on the maximum likelihood method, including HEV sequences reported in several countries, was performed. Phylogeny analysis revealed that HEV amplification fragments from Antioquia's pigs were grouped in three clades within the sub-genotype 3a without a specific geographical structure, and were also genetically related to Japanese and American HEV sequences. This analysis provides the first approach on the genetic diversity and circulation dynamics of HEV in Colombian herds.     

Infection dynamics of hepatitis E virus in naturally infected pigs in a Chinese farrow-to-finish farm

To analyze the changes that occur in pigs during hepatitis E virus (HEV) infection, 256 serial serum samples were obtained from 32 pigs from one pig farm at ages 0 (cord blood), 15, 30, 60, 75, 90, 120, and 150 days. All HEV markers were assayed in these samples and showed that total anti-HEV antibodies and IgG formed two peaks. The first peak occurred at 0–60 days and the second after 75 days. No markers of infection, such as HEV RNA, antigen and anti-HEV IgM, were detectable during the first peak. Most newborn piglets (<24 h of age) were negative for total anti-HEV and IgG. However, colostrum from all of the sows had evidence of these antibodies. Thus, the anti-HEV in the first peak was assumed to be acquired from maternal milk. Some infectious markers were positive at the beginning of second peak. PCR products were cloned and sequenced and the results indicated those sequences belonged to HEV genotype 4. The antibody present during the second peak may be induced by natural infection with HEV. In conclusion, pigs are susceptible to HEV infection and may remain infectious after the first peak of anti-HEV antibody.     

Anti-HEV seroprevalence in the area of Lecce

Hepatitis E virus (HEV) is the causative agent of an enterically transmitted viral hepatitis associated with inadequate hygienic conditions. Hepatitis E is endemic in developing countries where it occurs both in sporadic and epidemic form. Outbreaks have been reported in different areas of the world. The aim of the present work was to assess the seroprevalence of HEV infection in the general population and in different risk groups in the area of Lecce. The presence of anti-HEV antibodies was ascertained by qualitative ELISA (Abbott HEV EIA) and Western Blot (Recomblot HEV IgG/IgM, Mikrogen). The prevalence of anti-HEV in the general population was 2.9% while in intravenous drug users, hemodialized patients and immigrants the seroprevalence rates were 0.7%, 4.3% and 15.3% respectively. Our data show a circulation of HEV at low level in the area of Lecce which is endemic for hepatitis A. Higher seroprevalence rates were found in hemodialized patients and remarkably in immigrants coming from endemic areas like Turkey.     

Interpreting the transmissibility of measles in two different post periods of supplementary immunization activities in Hubei,China

Although evidence has shown that supplementary immunization activity (SIA) campaigns greatly reduce the incidence of measles, their effects on disease transmissibility have seldom been monitored. A great decrease in the number of cases may be a false signal of early success towards measles elimination to policy makers. By interpreting the transmissibility in two different post-SIA periods in Hubei, China, the current study showed sustained measles transmissions despite a reduced number of cases. Two population-based cross-sectional serological surveys of measles antibodies were conducted in Hubei province in mid-2010 and mid-2011 after the implementation of SIAs. Immunoglobulin G (IgG) antibodies against measles were measured by enzyme-linked immunosorbent assay (ELISA). Based on the estimated age-specific susceptibility levels, the effective reproduction number (R), a key indicator of disease transmissibility, was determined by the next generation matrix in transmission model. The results revealed an overall IgG seroprevalence of 88.0% (95% confidence interval [CI]: 85.6–90.4%) and 89.6% (95%CI: 88.0–91.2%), respectively, in the two different periods. Comparatively lower seroprevalence rates were observed among children less than 24 months of age and young adults 15 to 19 years of age in 2011. The Rs were 0.76 and 1.53 for the two study periods. In conclusion, even though the incidence was reduced to below 1/100,000 in both 2010 and 2011, the reproduction number in 2011 indicates a high risk for sustained measles transmission. This finding was potentially due to a lower seropositivity rate among young adults that had not been covered in the first SIA. Thus, implementation of SIA targeted to appropriate age groups is recommended. Regular monitoring of seroprevalence is also suggested to track disease transmissibility and to align SIA with the appropriate age groups.     

Measles epidemics and seroepidemiology of population in Wujin,Changzhou city,Jiangsu province,China 2015

The measles epidemic was rather severe in Wujin 2015, and a seroprevalence survey of measles antibody was conducted during June to September 2015 in Wjin district of Changzhou city. Blood samples were collected from community health population and convenient samples of residual blood from hospitals. Measles-specific IgG levels were measured by ELISA assay. A total of 122 measles cases were reported 2015 in Wujin district with an incidence of 8.31 per 100 000 populations. A large proportion of measles cases were adults ≥20 years (62.30%) and infants aged <18 months (28.69%). Floating population accounted for 68.57% of all cases. 1070 blood samples aged from 9 months to 49 years old were collected and the overall seroprevalence and geometric mean titer (GMT) of measles were 82.71% and 551.19 mIU/ml, respectively. Although the seroprevalence among children aged 9 months to 4 years was consistently over 90%, it began to decrease since 24 months, and till the age of ≥10 years, the seroprevalences were all <80%, however, the seroprevalence rised to above 80% in people over 40 years. There were no significant differences between the two blood sample sources in the level of seroprevalence and GMT. Also no significant differences were observed in the seroprevalence of measles and GMT levels between genders. The seroprevalence and GMT in people with measles vaccination were higher than those without measles vaccination or people whose measles vaccination are unknown (P < 0.001). Our study indicated that the adult measles cases have become a serious problem in Wujin district, which may mainly relate to the increasing size of the floating population with low measles vaccine coverage. The seroprevalence of measles decreased dramatically with increasing age since teenagers, which may mainly caused by waning vaccine-induced immunity. Therefore, it is necessary to strengthen measles vaccine in these people especially floating population.     

孝感市HIV感染人群的戊肝血清流行病学特征分析

目的 了解孝感市人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染人群的戊型肝炎病毒（hepatitis E viral,HEV）流行情况,为更有效地开展艾滋病和戊肝防治工作提供科学依据。方法 采集2015年5月~2016年9月203份HIV感染人群的血清样本,从中国疾病控制信息系统收集孝感市203名HIV感染人群的人口学资料、其他疾病感染史、实验室数据,血清进行抗-HEV IgG、抗-HEV IgM、HEV抗原（HEV antigen,HEV-Ag）筛查,并对抗-HEV IgM阳性进行肝功能筛查。结果 203名HIV感染人群抗-HEV IgM阳性率为2.46%,抗-HEV IgG阳性率为46.31%（94/203）。抗-HEV IgG阳性率在性别上差异无统计学意义（χ2=0,P=0.996）。离异组抗-HEV IgG阳性率高达80%,与其他婚姻状况组的差异有统计学意义（均有P<0.05）。CD4值≤ 200 cell/μl的人群抗-HEV IgG阳性率与CD4>200 cell/μl的人群抗-HEV IgG阳性率差异无统计学意义（χ2=0.286,P=0.593）;2个抗-HEV IgM阳性患者的CD4值分别为189 cell/μl和199 cell/μl,且1个肝功能异常。7个县市区抗-HEV IgG阳性率差异无统计学意义（χ2=5.906,P=0.551）。结论 孝感市HIV感染人群HEV感染较高,积极开展两病双向筛查的同时需采取有针对性地预防和治疗措施。     

Seroepidemiology and genetic characterization of hepatitis E virus in the northeast of china

The aim of this study was to analyze the prevalence of infection and genotype of hepatitis E virus (HEV) in people and animals in the northeast of China (Heilongjiang, Jilin and Liaoning provinces). This seroepidemiological study was conducted using enzyme immunoassays and human sera positive for HEV antigen or anti-HEV IgM, and animal sera positive for HEV antigen or with an S/CO ≤10 for anti-HEV were tested for HEV RNA using real-time RT-PCR and nested RT-PCR. In humans, the overall prevalence of anti-HEV IgG was 31.6% (311/985), 28.6% (147/514) and 21.1% (841/3994) in individuals frequent, infrequent, and very rare contact with swine, respectively. The overall prevalence of anti-HEV was 81.6% (1737/2127) in pigs above 3 months of age, 66.4% (1644/2473) in pigs below 3 months of age, 18.7% (301/1612) in cattle and 12.4% (162/1302) in sheep. 1211 samples were tested for HEV RNA using real-time RT-PCR and 71 were positive. 30 of the 71 samples also were positive for HEV RNA using nested RT-PCR. These 30 isolates shared 81.2–100% sequence identity with each other at the nucleotide level and belonged to HEV genotype 4, regardless whether from human or animals. The results indicate that HEV infection is widely spread in the northeast of China. The prevalence of anti-HEV in individuals with frequent contact with pigs was significantly higher than those without and the HEV sequences isolated from such individuals were related more closely to isolates from pigs. These support strongly the hypothesis of a zoonotic origin of hepatitis E.     

福建省戊型肝炎病毒感染的血清流行病学调查

目的了解福建省动物种群及人群中戊型肝炎病毒(HEV)的感染情况。方法收集猪、犬、乳牛、山羊和啮齿动物(黄胸鼠及褐家鼠)等5种与人类关系密切的哺乳动物血清标本共1151份,收集普通人群血清标本2209份,暴露人群血清标本1722份,应用ELISA检测抗-HEV IgG抗体。结果不同动物HEV感染率有差异(x2=406.25,P<0.01),其中猪的感染率为71.31%,散养家猪(70.00%-94.12%)HEV感染率高于大型专业养猪场(39.77%),不同生长期(≥4月龄)的猪其HEV感染率未见不同。普通人群HEV的阳性率为23.3%,暴露人群HEV阳性率为33.3%;暴露人群阳性率显著高于普通人群。在暴露人群中与鸡密切接触者,HEV的阳性率显著高于与猪密切接触者。HEV阳性率有随年龄的增长而上升的趋势,在普通人群中,男、女性HEV阳性率差异无统计学意义(P>0.05);但在暴露人群中男性HEV阳性率显著高于女性。结论猪和暴露人群HEV的感染率较高;与猪、鸡密切接触者HEV阳性率高于普通人群,证明了HEV可能是一种人兽共患病。     

湖北省HIV感染人群戊型肝炎流行病学调查

  目的  了解湖北省人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染人群中戊型肝炎病毒(hepatitis E virus,HEV)的流行情况,为戊型肝炎和艾滋病防治提供有效依据。  方法  于2017年1~6月在湖北省不同地域收集335例HIV感染人群血清样本并进行抗-HEV IgM、抗-HEV IgG检测。  结果  335名HIV感染人群的抗-HEV IgG阳性率为41.49%(139/335),抗-HEV IgM阳性率为0.89%(3/335)。抗-HEV IgG阳性率与年龄无线性相关(χ_趋势2=0.756,P=0.385),各年龄组间差异均无统计学意义(均有P>0.05)。男女性抗-HEV IgG阳性率差异无统计学意义(χ2=0.085,P=0.771)。CD4 ≤ 200 cell/μl与CD4>200 cell/μl两组间抗-HEV IgG阳性率差异无统计学意义(χ2=1.016,P=0.314)。三例抗-HEV IgM阳性CD4值分别为222 cell/μl,446 cell/μl和198 cell/μl。湖北省东部(30.77%,32/1 041)与中部(47.92%,46/96)HIV感染人群抗-HEV IgG阳性率差异有统计学意义(χ2=6.169,P=0.013),与东南部抗-HEV IgG阳性率差异有统计学意义(χ2=5.034,P=0.025)。  结论  湖北省HEV病毒在HIV感染人群中流行度较高,需要进行进一步研究并及时采取有效措施进行预防控制。     

湖北地区出口猪及不同人群中戊型肝炎病毒感染调查研究

〔目的〕调查湖北地区出口猪以及不同人群中戊型肝炎病毒的流行情况,为制定预防措施提供依据。〔方法〕从湖北地区8个出口猪场中共采集3个月龄以下猪的血清203份,3个月以上猪的血清637份。从不同人群(包括猪场和屠宰厂从业人员、农村居民以及献血员中共采集1585份血清样品。用酶联免疫方法分别检测戊型肝炎病毒抗体以及抗原,对部分样品采用实时荧光聚合酶链反应检测戊型肝炎病毒核酸。〔结果〕3个月龄以下和3个月龄以上猪血清中戊型肝炎病毒抗体的阳性率分别为56.65%和87.13%,2者间差异具有显著性(t=7.79,p<0.01);戊型肝炎病毒抗原的阳性率分别为9.35%和10.36%,2者间差异无显著性。在328份猪血清中,抗原和核酸的符合率为78.80%。猪场和屠宰厂从业人员、农村居民以及献血员中戊型肝炎病毒IgG抗体的阳性率分别为55.72%(263/472)、31.63%(99/313)、27.00%(81/300)和33.40%(167/500)。猪场从业人员戊型肝炎病毒IgG抗体阳性率与其他3类人群的相比,具有非常显著性差异(t=8.88,p<0.01)。〔结论〕猪群中戊型肝炎感染率较高,与猪密切接触人群的感染率高于其他人群。因此,应加强出口猪场的管理,减少戊型肝炎病毒在人畜之间的传播。     

Assessment of the cross-protective capability of recombinant capsid proteins derived from pig, rat, and avian hepatitis E viruses (HEV) against challenge with a genotype 3 HEV in pigs

Hepatitis E virus (HEV), the causative agent of hepatitis E, is primarily transmitted via the fecal-oral route through contaminated water supplies, although many sporadic cases of hepatitis E are transmitted zoonotically via direct contact with infected animals or consumption of contaminated animal meats. Genotypes 3 and 4 HEV are zoonotic and infect humans and other animal species, whereas genotypes 1 and 2 HEV are restricted to humans. There exists a single serotype of HEV, although the cross-protective ability among the animal HEV strains is unknown. Thus, in this study we expressed and characterized N-terminal truncated ORF2 capsid antigens derived from swine, rat, and avian HEV strains and evaluated their cross-protective ability in a pig challenge model. Thirty, specific-pathogen-free, pigs were divided into 5 groups of 6 pigs each, and each group of pigs were vaccinated with 200μg of swine HEV, rat HEV, or avian HEV ORF2 antigen or PBS buffer (2 groups) as positive and negative control groups. After a booster dose immunization at 2 weeks post-vaccination, the vaccinated animals all seroconverted to IgG anti-HEV. At 4 weeks post-vaccination, the animals were intravenously challenged with a genotype 3 mammalian HEV, and necropsied at 4 weeks post-challenge. Viremia, fecal virus shedding, and liver histological lesions were compared to assess the protective and cross-protective abilities of these antigens against HEV challenge in pigs. The results indicated that pigs vaccinated with truncated recombinant capsid antigens derived from three animal strains of HEV induced a strong IgG anti-HEV response in vaccinated pigs, but these antigens confer only partial cross-protection against a genotype 3 mammalian HEV. The results have important implications for the efficacy of current vaccines and for future vaccine development, especially against the novel zoonotic animal strains of HEV.     

Maternally acquired IgG immunity in neonates born to renal transplanted women

Neonates born to renal transplanted women are exposed in utero to immunosuppressors and to antenatal conditions that may predispose the neonate to a high risk of prematurity and intrauterine growth retardation. These factors might interfere with the transfer of maternal IgG immunity. Total IgG levels and specific antibodies to measles, varicella, tetanus, Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (serotypes 4,6B,9V,14,18C,19F and 23F) were evaluated on maternal and cord blood samples of 23 sets of renal transplanted women and their newborns and 32 sets of healthy women-newborns at term. Total IgG levels were measured by nephelometry and specific antibodies, by ELISA. Renal transplanted mothers had lower median tetanus antibodies (0.67 IU/mL) than controls (1.53 IU/mL; p = 0.017). Neonates from renal transplanted mothers had lower median tetanus antibodies (0.95 IU/mL) than controls (1.97 IU/mL, p = 0.008). Antibodies to measles, varicella, Hib and the 7 serotypes of S. pneumoniae were similar between groups. Maternal antibodies were associated with an increase in neonatal antibodies for all antigens; gestational age was associated with an increase in Hib neonatal antibodies. Preeclampsia was associated with a decrease in neonatal total IgG and serotype 4 S. pneumoniae antibodies; chronic hypertension was associated with a decrease in neonatal serotype 6B S. pneumoniae antibodies. As neonates from transplanted women may be born with lower tetanus antibodies than controls, efforts should be made to keep maternal vaccines up-to-date. Clinical antenatal care with control of preeclampsia, chronic hypertension and prevention of premature delivery might also contribute to neonatal antibody levels to specific antigens at birth.