title: Human immunodeficiency virus load in breast milk, mastitis, and mother-to-child transmission of human immunodeficiency virus type 1.
abstract: Human immunodeficiency virus (HIV) type 1 load in breast milk and mastitis were examined as risk factors for vertical transmission of HIV-1. Six weeks after delivery, HIV-1 load and sodium (an indicator of mastitis) were measured in breast milk from 334 HIV-1-infected women in Malawi. Median breast milk HIV-1 load was 700 copies/mL among women with HIV-1-infected infants versus undetectable (<200 copies/mL) among those with uninfected infants, respectively (P<. 0001). Elevated breast milk sodium levels consistent with mastitis occurred in 16.4% of HIV-1-infected women and were associated with increased vertical transmission of HIV-1 (P<.0001). Median breast milk HIV-1 load was 920 copies/mL among women with versus undetectable among those without elevated breast milk sodium levels, respectively (P<.0001). Mastitis and breast milk HIV-1 load may increase the risk of vertical transmission of HIV-1 through breast-feeding.
authors.affiliation: Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA. rdsemba@jhmi.edu
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: N
authors.initials: N
authors.lastname: Kumwenda
authors.forename: D R
authors.initials: DR
authors.lastname: Hoover
authors.forename: T E
authors.initials: TE
authors.lastname: Taha
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
authors.forename: L
authors.initials: L
authors.lastname: Mtimavalye
authors.forename: R J
authors.initials: RJ
authors.lastname: Biggar
authors.forename: R
authors.initials: R
authors.lastname: Broadhead
authors.forename: P G
authors.initials: PG
authors.lastname: Miotti
authors.forename: L J
authors.initials: LJ
authors.lastname: Sokoll
authors.forename: L
authors.initials: L
authors.lastname: van der Hoeven
authors.forename: J D
authors.initials: JD
authors.lastname: Chiphangwi
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008295:Malawi / Q000453:epidemiology; D008413:Mastitis / Q000453:epidemiology / Q000821:virology*; D008895:Milk, Human / Q000737:chemistry / Q000821:virology*; D015999:Multivariate Analysis; D012307:Risk Factors; D012964:Sodium / Q000032:analysis; D019562:Viral Load
chemical_list: D012964:Sodium