Human immunodeficiency virus type 1-infected cells in breast milk: association with immunosuppression and vitamin A deficiency.
Breast milk samples from human immunodeficiency virus type 1 (HIV-1)-seropositive women were analyzed by polymerase chain reaction to determine the prevalence and determinants of HIV-1-infected cells in breast milk. Breast milk samples (212) were collected from 107 women, and 58% of the samples had detectable HIV-1 DNA. The proportion of HIV-1-infected cells in the milk samples ranged from 1 to 3255/10(4) cells. Breast milk samples with detectable HIV-1 DNA were more likely to be from women with absolute CD4 cell counts of < 400 (odds ratio, 3.1; 95% confidence interval [CI], 1.5-7.0). Severe vitamin A deficiency (< 20 micrograms/dL) was associated with a 20-fold increased risk of having HIV-1 DNA in breast milk among women with < 400 CD4 cells/mm3 (95% CI, 2.1-188.5). Women with CD4 cell depletion, especially those with vitamin A deficiency, may be at increased risk of transmitting HIV-1 to their infants through breast milk.
Nduati
R W
RW
Department of Pediatrics, University of Nairobi, Kenya.
John
G C
GC
Richardson
B A
BA
Overbaugh
J
J
Welch
M
M
Ndinya-Achola
J
J
Moses
S
S
Holmes
K
K
Onyango
F
F
Kreiss
J K
JK
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007108:Immune Tolerance; D018445:Infectious Disease Transmission, Vertical; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy; D014802:Vitamin A Deficiency / Q000821:virology*