title: 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.
abstract: 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.
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA. ballardk@berkeley.edu
authors.forename: Kiersten
authors.initials: K
authors.lastname: Israel-Ballard
authors.forename: Caroline
authors.initials: C
authors.lastname: Chantry
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dewey
authors.forename: Bo
authors.initials: B
authors.lastname: Lönnerdal
authors.forename: Haynes
authors.initials: H
authors.lastname: Sheppard
authors.forename: Richard
authors.initials: R
authors.lastname: Donovan
authors.forename: James
authors.initials: J
authors.lastname: Carlson
authors.forename: Allyson
authors.initials: A
authors.lastname: Sage
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
mesh_terms: 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*