title: Effects of lipolysis or heat treatment on HIV-1 provirus in breast milk.
abstract: BACKGROUND
  Transmission of HIV-1 infection through breastfeeding is associated with integrated DNA (provirus) in milk cells. Reduction of HIV-1 DNA in milk may lessen infectivity.
  
  
  OBJECTIVE
  To investigate efficacy of two methods available in developing countries to reduce HIV-1 proviral DNA in breast milk.
  
  
  METHODS
  Methods simulated field conditions; milk was heated by bringing it to a boil, for instance, over a cooking fire, and lipolysis was done at room temperature. Four HIV-positive pregnant women were recruited for this pilot study, instructed to feed formula exclusively, and to stimulate milk production using pumping. Milk was collected twice weekly for 3 weeks and analyzed qualitatively for HIV-1 proviral DNA by polymerase chain reaction at three stages: 1) fresh, 2) after standing for 6 hours, and 3) after having been brought to the boiling point.
  
  
  RESULTS
  Seventeen samples from 4 mothers were analyzed. Fifteen of 17 fresh samples (88%) had measurable HIV-1 proviral DNA despite all mothers' having had low or undetectable plasma viral loads. Lipolysis (standing at room temperature) for 6 hours did not destroy proviral DNA: 6 of 7 samples (86%) tested positive for DNA after lipolysis. No samples of milk (n = 8) brought to a boil were positive for HIV-1 proviral DNA (p <.0001).
  
  
  CONCLUSIONS
  This preliminary evidence suggests that inherent lipolytic activity of fresh breast milk is inadequate for destruction of HIV-1; bringing breast milk to a boil may result in decreased HIV-1 infectivity; and breast milk cell-associated HIV-1 may not reflect plasma viral load. Nutritional value or possible bacterial contamination of milk treated in this manner was not assessed.
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, California, USA. caroline.chantry@ucdmc.ucdavis.edu
authors.forename: C J
authors.initials: CJ
authors.lastname: Chantry
authors.forename: P
authors.initials: P
authors.lastname: Morrison
authors.forename: J
authors.initials: J
authors.lastname: Panchula
authors.forename: C
authors.initials: C
authors.lastname: Rivera
authors.forename: G
authors.initials: G
authors.lastname: Hillyer
authors.forename: C
authors.initials: C
authors.lastname: Zorilla
authors.forename: C
authors.initials: C
authors.lastname: Diaz
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006358:Hot Temperature; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008066:Lipolysis; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy; D011533:Proviruses / Q000302:isolation & purification*; D014766:Viremia / Q000821:virology
chemical_list: D004279:DNA, Viral