BACKGROUND: Up to 40% of all mother-to-child transmission of HIV occurs by means of breast-feeding; yet, in developing countries, infant formula may not be a safe option. The World Health Organization recommends heat-treated breast milk as an infant-feeding alternative. We investigated the ability of a simple method, flash-heat, to inactivate HIV in breast milk from HIV-positive mothers. METHODS: Ninety-eight breast milk samples, collected from 84 HIV-positive mothers in a periurban settlement in South Africa, were aliquoted to unheated control and flash-heating. Reverse transcriptase (RT) assays (lower detection limit of 400 HIV copies/mL) were performed to differentiate active versus inactivated cell-free HIV in unheated and flash-heated samples. RESULTS: We found detectable HIV in breast milk samples from 31% (26 of 84) of mothers. After adjusting for covariates, multivariate logistic regression showed a statistically significant negative association between detectable virus in breast milk and maternal CD4+ T-lymphocyte count (P=0.045) and volume of breast milk expressed (P=0.01) and a positive association with use of multivitamins (P=0.03). All flash-heated samples showed undetectable levels of cell-free HIV-1 as detected by the RT assay (P<0.00001). CONCLUSIONS: Flash-heat can inactivate HIV in naturally infected breast milk from HIV-positive women. Field studies are urgently needed to determine the feasibility of in-home flash-heating breast milk to improve infant health while reducing postnatal transmission of HIV in developing countries.
BACKGROUND: Up to 40% of all mother-to-child transmission of HIV occurs by means of breast-feeding; yet, in developing countries, infant formula may not be a safe option. The World Health Organization recommends heat-treated breast milk as an infant-feeding alternative. We investigated the ability of a simple method, flash-heat, to inactivate HIV in breast milk from HIV-positive mothers. METHODS: Ninety-eight breast milk samples, collected from 84 HIV-positive mothers in a periurban settlement in South Africa, were aliquoted to unheated control and flash-heating. Reverse transcriptase (RT) assays (lower detection limit of 400 HIV copies/mL) were performed to differentiate active versus inactivated cell-free HIV in unheated and flash-heated samples. RESULTS: We found detectable HIV in breast milk samples from 31% (26 of 84) of mothers. After adjusting for covariates, multivariate logistic regression showed a statistically significant negative association between detectable virus in breast milk and maternal CD4+ T-lymphocyte count (P=0.045) and volume of breast milk expressed (P=0.01) and a positive association with use of multivitamins (P=0.03). All flash-heated samples showed undetectable levels of cell-free HIV-1 as detected by the RT assay (P<0.00001). CONCLUSIONS: Flash-heat can inactivate HIV in naturally infected breast milk from HIV-positive women. Field studies are urgently needed to determine the feasibility of in-home flash-heating breast milk to improve infant health while reducing postnatal transmission of HIV in developing countries.
Authors: Mduduzi N N Mbuya; Jean H Humphrey; Florence Majo; Bernard Chasekwa; Alison Jenkins; Kiersten Israel-Ballard; Monica Muti; Keriann H Paul; Rufaro C Madzima; Lawrence H Moulton; Rebecca J Stoltzfus Journal: J Nutr Date: 2010-06-23 Impact factor: 4.798
Authors: Kiersten A Israel-Ballard; Barbara F Abrams; Anna Coutsoudis; Lindiwe N Sibeko; Lynn A Cheryk; Caroline J Chantry Journal: J Acquir Immune Defic Syndr Date: 2008-08-01 Impact factor: 3.731
Authors: Sera L Young; Mduduzi N N Mbuya; Caroline J Chantry; Eveline P Geubbels; Kiersten Israel-Ballard; Deborah Cohan; Stephen A Vosti; Michael C Latham Journal: Adv Nutr Date: 2011-04-30 Impact factor: 8.701
Authors: Renaud Becquet; Ruth Bland; Valériane Leroy; Nigel C Rollins; Didier K Ekouevi; Anna Coutsoudis; François Dabis; Hoosen M Coovadia; Roger Salamon; Marie-Louise Newell Journal: PLoS One Date: 2009-10-16 Impact factor: 3.240