title: Salivary secretory leukocyte protease inhibitor is associated with reduced transmission of human immunodeficiency virus type 1 through breast milk.
abstract: Secretory leukocyte protease inhibitor (SLPI), a protein found in saliva, breast milk, and genital secretions, is capable of inhibiting human immunodeficiency virus (HIV) type 1 in vitro. The aim of this study was to determine whether SLPI in infant saliva provides protection against mother-to-child HIV-1 transmission. In total, 602 saliva specimens were collected from 188 infants at birth and at ages 1, 3, and 6 months. Infants' median salivary SLPI concentrations were higher at birth than at 6 months (341 vs. 219 ng/mL; P=.001). There was no association between SLPI concentration and HIV-1 transmission overall. However, among 122 breast-fed infants who were HIV-1 uninfected at 1 month, higher salivary SLPI levels were associated with a decreased risk of HIV-1 transmission through breast milk (hazard ratio, 0.5; 95% confidence interval, 0.3-0.9; P=.03). These results suggest that SLPI plays an important role in reducing HIV-1 transmission through breast milk.
mesh_terms: D019380:Anti-HIV Agents / Q000032:analysis / Q000378:metabolism; D004198:Disease Susceptibility; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy; D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins / Q000032:analysis / Q000378:metabolism*; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry*; D053481:Secretory Leukocyte Peptidase Inhibitor
chemical_list: D019380:Anti-HIV Agents; D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins; C506814:SLPI protein, human; D053481:Secretory Leukocyte Peptidase Inhibitor