title: Hiv-specific secretory IgA in breast milk of HIV-positive mothers is not associated with protection against HIV transmission among breast-fed infants.
abstract: OBJECTIVE
  To test whether secretory immunoglobulin A (sIgA) to human immunodeficiency virus (HIV) antigens in breast milk of HIV-positive women is associated with protection against HIV transmission among breast-fed infants.
  
  
  METHODS
  Nested, case-control design in which HIV-specific sIgA was measured in breast milk collected from 90 HIV-positive women enrolled in a study in Lusaka, Zambia. Milk samples were selected to include 26 HIV-positive mothers with infected infants (transmitters) and 64 mothers with uninfected infants (nontransmitters).
  
  
  RESULTS
  HIV-specific sIgA was detected more often in breast milk of transmitting mothers (76.9%) than in breast milk of nontransmitting mothers (46.9%, P = .009). There were no significant associations between HIV-specific sIgA in breast milk and other maternal factors, including HIV RNA quantities in breast milk, CD4 count, and plasma RNA quantities.
  
  
  CONCLUSIONS
  HIV-specific sIgA in breast milk does not appear to be a protective factor against HIV transmission among breast-fed infants.
authors.affiliation: Gertrude H. Sergievsky Center and the 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: Moses
authors.initials: M
authors.lastname: Sinkala
authors.forename: Francesca
authors.initials: F
authors.lastname: Lissoni
authors.forename: Mrinal
authors.initials: M
authors.lastname: Ghosh
authors.forename: Grace
authors.initials: G
authors.lastname: Aldrovandi
authors.forename: Don
authors.initials: D
authors.lastname: Thea
authors.forename: Mario
authors.initials: M
authors.lastname: Clerici
mesh_terms: D000328:Adult; D000918:Antibody Specificity; D015415:Biomarkers / Q000097:blood; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000008:administration & dosage / Q000276:immunology*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008895:Milk, Human / Q000276:immunology*; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019562:Viral Load; D015024:Zambia
chemical_list: D015415:Biomarkers; D007071:Immunoglobulin A, Secretory; D012367:RNA, Viral