Viral, nutritional, and bacterial safety of flash-heated and pretoria-pasteurized breast milk to prevent mother-to-child transmission of HIV in resource-poor countries: a pilot study.
BACKGROUND
Heat-treated breast milk of HIV-positive mothers has potential to reduce vertical transmission. This study compared the impact of flash-heating (FH) and Pretoria pasteurization (PP) on HIV, nutrients, and antimicrobial properties in human milk.


METHODS
Milk samples were spiked with 1 x 10 (8) copies/mL of clade C HIV-1 and treated with FH and PP. We measured HIV reverse transcriptase (RT) activity before and after heating (n = 5). Heat impact on vitamins A, B6, B12, and C; folate, riboflavin, thiamin, and antimicrobial proteins (lactoferrin and lysozyme) was assessed. Storage safety was evaluated by spiking with Escherichia coli or Staphylococcus aureus.


RESULTS
Both methods inactivated > or = 3 logs of HIV-1. FH resulted in undetectable RT activity. Neither method caused significant decrease in any vitamin, although reductions in vitamins C and E were noted. Heat decreased immunoreactive lactoferrin (P < 0.05) but not the proportions of lactoferrin and lysozyme surviving digestion. FH seems to retain more antibacterial activity. Both treatments eliminated spiked bacteria.


CONCLUSIONS
FH may be superior to PP in eliminating all viral activity; both methods retained nutrients and destroyed bacterial contamination. Heat-treated breast milk merits further study as a safe and practical infant feeding option for HIV-positive mothers in developing countries.
Israel-Ballard
Kiersten
K
Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA. ballardk@berkeley.edu
Chantry
Caroline
C
Dewey
Kathryn
K
Lönnerdal
Bo
B
Sheppard
Haynes
H
Donovan
Richard
R
Carlson
James
J
Sage
Allyson
A
Abrams
Barbara
B
D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006358:Hot Temperature; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000737:chemistry / Q000382:microbiology / Q000821:virology; D009753:Nutritive Value; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*