US and Kenyan researchers proved that breast milk from HIV-infected mothers contributes to the vertical transmission of HIV-1. Specifically, they found that the prevalence of cell-free HIV-1 was higher in mature milk (47%) than in colostrum (27%).
Breast milk has been suggested as an important source of vertical HIV transmission, Dr. Paul Lewis of Oregon Health Sciences University in Portland and colleagues explain. However, they believe that this is the first study using a highly sensitive PCR assay for viral RNA to detect cell-free HIV-1 in breast milk.
Dr. Lewis' group analyzed samples of breast milk from HIV-positive women in Nairobi. HIV-1 RNA was detected in 29 (39%) of 75 specimens tested. About half of the 29 specimens contained HIV-1 RNA levels near the limit of detection, and 21% of the samples had more than 900 copies/mL. The maximum concentration of HIV-1 RNA detected was 8,100 copies/mL.
Overall, the prevalence of HIV-1 RNA did not decrease as the milk supply matured. Dr. Lewis' team concluded that transmission risk is likely to be related to the quantity of HIV-1 in cell-free breast milk in addition to other factors, such as number of HIV-1-infected cells in breast milk, the presence of antiviral substances in breast milk, and factors determining infant susceptibility.
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