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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Human milk oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding
American Journal of Clinical Nutrition, Volume 96, No. 4, Year 2012
Notification
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Description
Background: The inefficiency of HIV breast-milk transmission may be caused by the presence of immunologically active factors, including human milk oligosaccharides (HMOs). Objective: We investigated whether HMO concentrations are associated with a reduced risk of postnatal HIV transmission. Design: A nested case-control study was conducted within a larger cohort study of HIV-infected women and their infants followed from birth to 24 mo in Lusaka, Zambia. Breast-milk samples collected at 1 mo from 81 HIV-infected women who transmitted via breastfeeding, a random sample of 86 HIV-infected women who did not transmit despite breastfeeding, and 36 uninfected breastfeeding women were selected. Total and specific HMO concentrations were measured by HPLC and compared between groups with adjustment for confounders by using logistic regression. Results: HIV-infected women with total HMOs above the median (1.87 g/L) were less likely to transmit via breastfeeding (OR: 0.45; 95% CI: 0.21, 0.97; P = 0.04) after adjustment for CD4 count and breast-milk HIV RNA concentrations; a trend toward higher concentrations of lacto-N-neotetraose being associated with reduced transmission (OR: 0.49; 95% CI: 0.23, 1.04; P = 0.06) was also observed. The proportion of 3′-sialyllactose (3′-SL) per total HMOs was higher among transmitting than among nontransmitting women (P = 0.003) and correlated with higher plasma and breast-milk HIV RNA and lower CD4 counts. Neither Secretor nor Lewis status distinguished between transmitting and nontransmitting women. Conclusions: Higher concentrations of non-3′-SL HMOs were associated with protection against postnatal HIV transmission independent of other known risk factors. Further study of these novel, potentially anti-HIV components of breast milk is warranted. This trial was registered at clinicaltrials.gov as NCT00310726. © 2012 American Society for Nutrition.
Authors & Co-Authors
Bode, Lars
United States, La Jolla
Uc San Diego School of Medicine
Kuhn, Louise
United States, New York
Mailman School of Public Health
Kim, Hae-young
United States, New York
Mailman School of Public Health
Hsiao, Lauren
United States, La Jolla
Uc San Diego School of Medicine
Nissan, Caroline
United States, La Jolla
Uc San Diego School of Medicine
Sinkala, Moses M.
Zambia, Lusaka
Lusaka District Health Management Team
Kankasa, Chipepo
Zambia, Lusaka
University Teaching Hospital Lusaka
Mwiya, Mwiya
Zambia, Lusaka
University Teaching Hospital Lusaka
Thea, Donald M.
United States, Boston
Boston University
Aldrovandi, Grace M.
United States, Los Angeles
University of Southern California
Statistics
Citations: 106
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.3945/ajcn.112.039503
ISSN:
00029165
e-ISSN:
19383207
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Study Locations
Zambia
Participants Gender
Female