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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Role of intestinal mucosal integrity in HIV transmission to infants through breast-feeding: The BAN study
Journal of Infectious Diseases, Volume 208, No. 4, Year 2013
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Description
Background. Increased intestinal permeability may be one of the mechanisms of transmission of human immunodeficiency virus (HIV) to infants through breast-feeding. Intestinal permeability correlates with microbial translocation, which can be measured through quantification of bacterial lipopolysaccharide (LPS). Methods. We evaluated levels of plasma LPS (by the Limulus amebocyte lysate assay) and immune activation markers in serial specimens from infants exposed to but uninfected with HIV and infants infected with HIV from the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study. Results. Plasma LPS levels increased after infants in the BAN study were weaned from the breast, at 24 weeks of age. Cotrimoxazole prophylaxis was associated with higher plasma LPS levels (P =. 004). Infants with HIV infection had higher LPS levels, compared with uninfected infants (P =. 004). Higher preinfection plasma LPS levels were a significant predictor of infant HIV infection through breast-feeding (hazard ratio = 1.60 for every unit increase in plasma LPS level; P =. 01) and of lower infant length-for-age z scores (P =. 02). Conclusions. These findings suggest that disruption in intestinal integrity is a mechanism of HIV transmission to infants through breast-feeding. Weaning from breast milk and use of antibiotic prophylaxis was associated with increased levels of microbial translocation, which could facilitate HIV entry through the intestine. Complementary approaches to enhance intestinal mucosal integrity in the infant may further reduce breast-feeding transmission of HIV. © The Author 2013.
Authors & Co-Authors
Kourtis, Athena P.
United States, Atlanta
National Center for Chronic Disease Prevention and Health Promotion
Ibegbu, Chris C.
United States, Atlanta
Emory University
Wiener, Jeffrey B.
United States, Atlanta
National Center for Chronic Disease Prevention and Health Promotion
King, Caroline C.
United States, Atlanta
National Center for Chronic Disease Prevention and Health Promotion
Tegha, Gerald L.
Malawi, Lilongwe
Unc Project-malawi
Kamwendo, Deborah D.
Malawi, Lilongwe
Unc Project-malawi
Kumwenda, Jacob
Malawi, Lilongwe
Unc Project-malawi
Kaur, Surinder P.
United States, Atlanta
Emory University
Flax, Valerie L.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Ellington, Sascha R.
United States, Atlanta
National Center for Chronic Disease Prevention and Health Promotion
Kacheche, Zebrone K.
Malawi, Lilongwe
Unc Project-malawi
Kayira, Dumbani
Malawi, Lilongwe
Unc Project-malawi
Chasela, Charles S.
Malawi, Lilongwe
Unc Project-malawi
van der Horst, Charles Michael
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Jamieson, Denise J.
United States, Atlanta
National Center for Chronic Disease Prevention and Health Promotion
Statistics
Citations: 36
Authors: 15
Affiliations: 4
Identifiers
Doi:
10.1093/infdis/jit221
ISSN:
00221899
Research Areas
Environmental
Food Security
Infectious Diseases
Maternal And Child Health