title: Alpha-defensins in the prevention of HIV transmission among breastfed infants.
abstract: Alpha-defensins have been observed to have anti-HIV activity but have not been investigated in relation to mother-to-child HIV transmission. We measured the concentration of alpha-defensins in breast milk of HIV-positive mothers and tested whether the concentrations were associated with HIV transmission. A nested case-control study of 32 HIV-positive women who transmitted HIV to their infants and 52 randomly selected HIV-positive women who did not transmit HIV to their infants was conducted in Lusaka, Zambia. alpha-Defensins were detected in most (79%) of the milk samples tested. Concentrations of alpha-defensins increased as breast milk HIV RNA quantity increased, and breast milk HIV RNA quantity was, in turn, a strong and significant predictor of HIV transmission. After adjustment for milk HIV RNA quantity, however, alpha-defensin concentration was significantly associated with a decreased risk of intrapartum and postnatal HIV transmission (odds ratio = 0.3, 95% confidence interval: 0.09-0.93). Our data suggest that there may be a role for alpha-defensins in prevention of HIV transmission to breastfed infants.
authors.affiliation: Gertrude H. Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. lk24@columbia.edu
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
authors.forename: Daria
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Chipepo
authors.initials: C
authors.lastname: Kankasa
authors.forename: Katherine
authors.initials: K
authors.lastname: Semrau
authors.forename: Prisca
authors.initials: P
authors.lastname: Kasonde
authors.forename: Francesca
authors.initials: F
authors.lastname: Lissoni
authors.forename: Moses
authors.initials: M
authors.lastname: Sinkala
authors.forename: Mrinal
authors.initials: M
authors.lastname: Ghosh
authors.forename: Cheswa
authors.initials: C
authors.lastname: Vwalika
authors.forename: Grace M
authors.initials: GM
authors.lastname: Aldrovandi
authors.forename: Donald M
authors.initials: DM
authors.lastname: Thea
authors.forename: Mario
authors.initials: M
authors.lastname: Clerici
mesh_terms: D000328:Adult; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000737:chemistry* / Q000821:virology*; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics / Q000302:isolation & purification; D015024:Zambia; D023084:alpha-Defensins / Q000032:analysis*
chemical_list: D012367:RNA, Viral; D023084:alpha-Defensins