title: Breast-milk infectivity in human immunodeficiency virus type 1-infected mothers.
abstract: Human immunodeficiency virus type 1 (HIV-1) is transmitted through blood, genital secretions, and breast milk. The probability of heterosexual transmission of HIV-1 per sex act is.0003-.0015, but little is known regarding the risk of transmission per breast-milk exposure. We evaluated the probability of breast-milk transmission of HIV-1 per liter of breast milk ingested and per day of breast-feeding in a study of children born to HIV-1-infected mothers. The probability of breast-milk transmission of HIV-1 was.00064 per liter ingested and.00028 per day of breast-feeding. Breast-milk infectivity was significantly higher for mothers with more-advanced disease, as measured by prenatal HIV-1 RNA plasma levels and CD4 cell counts. The probability of HIV-1 infection per liter of breast milk ingested by an infant is similar in magnitude to the probability of heterosexual transmission of HIV-1 per unprotected sex act in adults.
authors.affiliation: Department of Biostatistics, University of Washington, Harborview Medical Center, Box 359909, 325 Ninth Avenue, Seattle, WA 98104-2499, USA. barbrar@u.washington.edu
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Ruth
authors.initials: R
authors.lastname: Nduati
authors.forename: Dorothy
authors.initials: D
authors.lastname: Mbori-Ngacha
authors.forename: Julie
authors.initials: J
authors.lastname: Overbaugh
authors.forename: Joan K
authors.initials: JK
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D002648:Child; D005260:Female; D015658:HIV Infections / Q000635:transmission* / Q000821:virology; D015497:HIV-1; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008895:Milk, Human / Q000821:virology*; D009035:Mothers; D011336:Probability; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D012367:RNA, Viral