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AIDS and Behavior
Published in: AIDS and Behavior 5/2012

01-07-2012 | Original Paper

Infant Feeding Practices were not Associated with Breast Milk HIV-1 RNA Levels in a Randomized Clinical Trial in Botswana

Authors: Raabya Rossenkhan, Vladimir Novitsky, Teresa K. Sebunya, Jean Leidner, Jose E. Hagan, Sikhulile Moyo, Laura Smeaton, Shahin Lockman, Rosemary Musonda, Thumbi Ndung’u, Simani Gaseitsiwe, Ibou Thior, Mompati Mmalane, Joseph Makhema, M. Essex, Roger Shapiro

Published in: AIDS and Behavior | Issue 5/2012

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Abstract

Exclusive breastfeeding has been associated with a reduced risk of late vertical HIV transmission as compared to an infant diet composed of breast milk mixed with supplemental foods or liquids. Hypothesized mechanisms include increased infectivity of breast milk from mothers who practice mixed breastfeeding (MBF), or mechanisms such as increased gastrointestinal permeability in the infant caused by mixed feeding. It has been proposed that MBF may result in subclinical mastitis and higher breast milk HIV titers. However, little is known about the relationship between feeding strategy and breast milk viral load. We measured the HIV-1 concentration in breast milk in a sub-cohort of women enrolled in a mother-to-child HIV transmission prevention trial (the “Mashi” study). We report no observed relationship between MBF and measured breast milk viral RNA load. Our findings suggest that the increased transmission risk associated with higher breast milk HIV-1 RNA during MBF is unlikely.
Literature
1.
Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the role of breastfeeding on the prevention of infant mortality. Lancet. 2000;355:451–5.
2.
Ahiadeke C. Breast-feeding, diarrhoea and sanitation as components of infant and child health: a study of large scale survey data from Ghana and Nigeria. J Biosoc Sci. 2000;32:47–61.PubMed
3.
Becquet R, Bequet L, Ekouevi DK, et al. Two-year morbidity-mortality and alternatives to prolonged breast-feeding among children born to HIV-infected mothers in Cote d’Ivoire. PLoS Med. 2007;4:e17.PubMedCrossRef
4.
Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African vitamin a study group. Lancet. 1999;354:471–6.PubMedCrossRef
5.
Creek T, Arvelo W, Kim A, et al. Role of infant feeding and HIV in a severe outbreak of diarrhea and malnutrition among young children, Botswana, 2006. In: CROI 2007: 14th Conference of retroviruses and opportunistic infections, Los Angeles, California, USA, February 25–28, 2007 Abstract 770.
6.
Iliff PJ, Piwoz EG, Tavengwa NV, et al. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005;19:699–708.PubMedCrossRef
7.
Kuhn L, Aldrovandi GM, Sinkala M, et al. Effects of early, abrupt weaning on HIV-free survival of children in Zambia. N Engl J Med. 2008;359:130–41.PubMedCrossRef
8.
Kuhn L, Sinkala M, Kankasa C, et al. High uptake of exclusive breastfeeding and reduced early post-natal HIV transmission. PLoS One. 2007;2:e1363.PubMedCrossRef
9.
Smith MM, Kuhn L. Exclusive breast-feeding: does it have the potential to reduce breast-feeding transmission of HIV-1? Nutr Rev. 2000;58:333–40.PubMedCrossRef
10.
Thomas T, Masaba R, van Eijk A, et al. Rates of diarrhea associated with early weaning among infants in Kisumu, Kenya. In: CROI 2007: 14th conference of retroviruses and opportunistic infections, Los Angeles, California, USA, February 25–28, 2007, Abstract 774.
11.
Dunn DT, Newell ML, Ades AE, Peckham CS. Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet. 1992;340:585–8.PubMedCrossRef
12.
Miotti PG, Taha TE, Kumwenda NI, et al. HIV transmission through breastfeeding: a study in Malawi. JAMA. 1999;282:744–9.PubMedCrossRef
13.
Coovadia HM, Rollins NC, Bland RM, et al. Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study. Lancet. 2007;369:1107–16.PubMedCrossRef
14.
Lunney KM, Iliff P, Mutasa K, et al. Associations between breast milk viral load, mastitis, exclusive breast-feeding, and postnatal transmission of HIV. Clin Infect Dis. 2010;50:762–9.PubMed
15.
16.
17.
Rollins NC, Filteau SM, Coutsoudis A, Tomkins AM. Feeding mode, intestinal permeability, and neopterin excretion: a longitudinal study in infants of HIV-infected South African women. J Acquir Immune Defic Syndr. 2001;28:132–9.PubMed
18.
Thea DM, Aldrovandi G, Kankasa C, et al. Post-weaning breast milk HIV-1 viral load, blood prolactin levels and breast milk volume. AIDS. 2006;20:1539–47.PubMedCrossRef
19.
Semba RD, Kumwenda N, Hoover DR, et al. Human immunodeficiency virus load in breast milk, mastitis, and mother-to-child transmission of human immunodeficiency virus type 1. J Infect Dis. 1999;180:93–8.PubMedCrossRef
20.
Willumsen JF, Filteau SM, Coutsoudis A, et al. Breastmilk RNA viral load in HIV-infected South African women: effects of subclinical mastitis and infant feeding. AIDS. 2003;17:407–14.PubMedCrossRef
21.
Thior I, Lockman S, Smeaton LM, et al. Breastfeeding plus infant zidovudine prophylaxis for 6 months vs formula feeding plus infant zidovudine for 1 month to reduce mother-to-child HIV transmission in Botswana: a randomized trial: the Mashi study. JAMA. 2006;296:794–805.PubMedCrossRef
22.
Shapiro RL, Thior I, Gilbert PB, et al. Maternal single-dose nevirapine versus placebo as part of an antiretroviral strategy to prevent mother-to-child HIV transmission in Botswana. AIDS. 2006;20:1281–8.PubMedCrossRef
23.
Sinkala M, Kuhn L, Kankasa C, et al. No benefit of early cessation of breastfeeding at 4 months on HIV-free survival of infants born to HIV-infected mothers in Zambia: the Zambia exclusive breastfeeding study. In: CROI 2007: 14th conference on retroviruses and opportunistic infections, Los Angeles, California, USA, February 25–28, 2007, Oral abstract LB 74.
24.
Koulinska IN, Villamor E, Chaplin B, et al. Transmission of cell-free and cell-associated HIV-1 through breast-feeding. J Acquir Immune Defic Syndr. 2006;41:93–9.PubMedCrossRef
25.
Rousseau CM, Nduati RW, Richardson BA, et al. Association of levels of HIV-1-infected breast milk cells and risk of mother-to-child transmission. J Infect Dis. 2004;190:1880–8.PubMedCrossRef
26.
Richardson BA, Nduati R, Mbori-Ngacha D, Overbaugh J, John-Stewart GC. Acute HIV infection among Kenyan infants. Clin Infect Dis. 2008;46:289–95.PubMedCrossRef
27.
Shapiro RL, Smeaton L, Lockman S, et al. Risk factors for early and late transmission of HIV via breast-feeding among infants born to HIV-infected women in a randomized clinical trial in Botswana. J Infect Dis. 2009;199:414–8.PubMedCrossRef
28.
Chung MH, Kiarie JN, Richardson BA, Lehman DA, Overbaugh J, John-Stewart GC. Breast milk HIV-1 suppression and decreased transmission: a randomized trial comparing HIVNET 012 nevirapine versus short-course zidovudine. AIDS. 2005;19:1415–22.PubMedCrossRef
29.
Chung MH, Kiarie JN, Richardson BA, et al. Highly active antiretroviral therapy versus zidovudine/nevirapine effects on early breast milk HIV type-1 Rna: a phase II randomized clinical trial. Antivir Ther. 2008;13:799–807.PubMed
30.
Chung MH, Kiarie JN, Richardson BA, et al. Independent effects of nevirapine prophylaxis and HIV-1 RNA suppression in breast milk on early perinatal HIV-1 transmission. J Acquir Immune Defic Syndr. 2007;46:472–8.PubMedCrossRef
31.
Manigart O, Crepin M, Leroy V, et al. Effect of perinatal zidovudine prophylaxis on the evolution of cell-free HIV-1 RNA in breast milk and on postnatal transmission. J Infect Dis. 2004;190:1422–8.PubMedCrossRef
32.
Rossenkhan R, Ndung’u T, Sebunya TK, et al. Temporal reduction of HIV type 1 viral load in breast milk by single-dose nevirapine during prevention of MTCT. AIDS Res Hum Retroviruses. 2009;25:1261–4.PubMedCrossRef
33.
Tovanabutra S, de Souza M, Sittisombut N, et al. HIV-1 genetic diversity and compartmentalization in mother/infant pairs infected with CRF01_AE. AIDS. 2007;21:1050–3.PubMedCrossRef
Metadata
Title
Infant Feeding Practices were not Associated with Breast Milk HIV-1 RNA Levels in a Randomized Clinical Trial in Botswana
Authors
Raabya Rossenkhan
Vladimir Novitsky
Teresa K. Sebunya
Jean Leidner
Jose E. Hagan
Sikhulile Moyo
Laura Smeaton
Shahin Lockman
Rosemary Musonda
Thumbi Ndung’u
Simani Gaseitsiwe
Ibou Thior
Mompati Mmalane
Joseph Makhema
M. Essex
Roger Shapiro
Publication date
01-07-2012
Publisher
Springer US
Published in
AIDS and Behavior / Issue 5/2012
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-011-0035-7

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