Infective and anti-infective properties of breastmilk from HIV-1-infected women

Autor: P. Van de Perre, Arlette Simonon, B. Mukamabano, D.G. Hitimana, C. Van Goethem, J.-B. Butera, Philippe Msellati, François Dabis, E. Karita, P. Lepage
Rok vydání: 1993
Předmět:
Time Factors
Human immunodeficiency virus (HIV)
HIV Infections
NOURRISSON
HIV Antibodies
medicine.disease_cause
Polymerase Chain Reaction
law.invention
Persistence (computer science)
Serology
law
Risk Factors
Lactation
Infant Mortality
Odds Ratio
Medicine
Prospective Studies
Polymerase chain reaction
education.field_of_study
medicine.diagnostic_test
biology
SIDA
Transmission (medicine)
Obstetrics and Gynecology
General Medicine
Survival Rate
Breast Feeding
medicine.anatomical_structure
Female
Viral disease
Antibody
ANTICORPS
TRANSMISSION
Offspring
Blotting
Western
Population
CD4-CD8 Ratio
Nerve Tissue Proteins
Breast milk
Virus
Western blot
Predictive Value of Tests
Humans
education
PCR.REACTION DE POLYMERISATION EN CHAINE
Analysis of Variance
Milk
Human
business.industry
NOUVEAU NE
Infant
Newborn
Rwanda
Infant
ALLAITEMENT MATERNEL
LAIT MATERNEL
VIRUS HIV-1
Virology
Immunoglobulin M
FEMME
Immunoglobulin G
DNA
Viral
Immunoglobulin A
Secretory
Multivariate Analysis
Immunology
HIV-1
biology.protein
business
TRANSMISSION FOETOMATERNELLE
Breast feeding
Zdroj: The Lancet. 341:914-918
ISSN: 0140-6736
DOI: 10.1016/0140-6736(93)91210-d
Popis: Human immunodeficiency virus type 1 (HIV-1) is transmitted mainly by cell-to-cell contact. We postulated that transmission of HIV-1 through breastmilk could be favoured by the presence of infected cells, by deficiency of anti-infective substances in breastmilk, or both factors. 215 HIV-1-infected women were enrolled at delivery in Kigali, Rwanda; milk samples were collected 15 days, 6 months, and 18 months post partum. HIV-1 IgG, secretory IgA, and IgM were assayed by western blot, for the latter two after removal of IgG with protein G. In the 15-day and 6-month samples, we sought viral genome in milk cells by a double polymerase chain reaction with three sets of primers (gag, pol, and env). HIV-1 infection in the offspring was defined according to serological and clinical criteria. At 15 days, 6 months, and 18 months post partum, HIV-1 specific IgG was detected in 95%, 98%, and 97% of breastmilk samples, IgA in 23%, 28%, and 41%, and IgM in 66%, 78%, and 41%. In children who survived longer than 18 months, the probability of infection was associated with lack of persistence of IgM and IgA in their mothers' milk (adjusted chi 2 for trend, p = 0.01 for IgM and p = 0.05 for IgA). The presence of HIV-1-infected cells in the milk 15 days post partum was strongly predictive of HIV-1 infection in the child, by both univariate (p0.05) and multivariate analysis (p = 0.01). The combination of HIV-1-infected cells in breastmilk and a defective IgM response was the strongest predictor of infection. HIV-1 infection in breastfed children born to infected mothers is associated with the presence of integrated viral DNA in the mothers' milk cells. IgM and IgA anti-HIV-1 in breastmilk may protect against postnatal transmission of the virus.
Databáze: OpenAIRE
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