期刊
JOURNAL OF INFECTIOUS DISEASES
卷 187, 期 5, 页码 741-747出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/374273
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资金
- FIC NIH HHS [D43 TW000007] Funding Source: Medline
- NCI NIH HHS [T32 CA009229, T32 CA 09229] Funding Source: Medline
- NIAID NIH HHS [P30 AI027757, P30 AI027757-15] Funding Source: Medline
- NICHD NIH HHS [K08 HD001160, HD 23412, R01 HD023412] Funding Source: Medline
Transmission of human immunodeficiency virus type 1 (HIV-1) via breast-feeding can occur throughout lactation. Defining both fluctuation in breast-milk virus level over time and how breast-milk virus correlates with mother-to-child transmission is important for establishing effective interventions. We quantified breast-milk HIV-1 RNA levels in serial samples collected from 275 women for up to 2 years after delivery. Higher maternal plasma virus load, lower maternal CD4 T cell count, and detection of HIV-1 DNA in maternal genital secretions were significantly associated with elevated breast-milk HIV-1 RNA. Within women who breast-fed, median virus load in colostrum/early milk was significantly higher than that in mature breast milk collected 14 days after delivery (Pless than or equal to.004). Breast-feeding mothers who transmitted HIV-1 to their infants had both significantly higher breast-milk viral RNA throughout lactation and more-consistent viral shedding, compared with mothers who did not transmit HIV-1. In breast-feeding women, a 2-fold-increased risk of transmission was associated with every 10-fold increase in breast-milk virus load (95% confidence interval, 1.3-3.0; P <.001). These results indicate that the risk of infant infection from breast-feeding is influenced by breast-milk virus load, which is highest early after delivery.
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