title: Hepatitis B viral markers in banked human milk before and after Holder pasteurization.
abstract: BACKGROUND
  Blood screening for hepatitis B virus (HBV) is not universally performed for donor selection in human milk banks.
  
  
  OBJECTIVE
  To evaluate the frequency of detection of HBV surface antigen (HBsAg) and HBV-DNA in colostrum of HBV-infected nursing mothers before and after Holder pasteurization.
  
  
  METHODS
  Forty-two concentrated breast milk samples were obtained within two postnatal weeks from 24 HBsAg-positive women (4 HBeAg-positive and 20 HBeAg-negative, anti-HBe-positive) were tested for the presence of HBsAg and HBV-DNA before and after Holder pasteurization (30min at 62.5 degrees C).
  
  
  RESULTS
  Before pasteurization, HBsAg and HBV-DNA were found in 14/24 (58%), and 20/24 (75%) first milk samples, respectively, obtained by 4 days after delivery. At least one marker was detected in 20/24 (83%) milk samples. Both markers were identified in milk of HBeAg-positive mothers, and most mothers with anti-HBe in blood had at least one HBV marker. Once detected, viral markers were frequently found in milk samples subsequently obtained from the same woman. Holder pasteurization did not affect the probability of detecting HBsAg (8/18, 44%), HBV-DNA (12/18, 67%), or at least one of them (15/18, 83%).
  
  
  CONCLUSIONS
  Although the biological implications of these findings remain to be determined, considering that HBV is highly contagious and most recipients of banked human milk are preterm infants, these findings should be taken into account when donors are enlisted for human milk banks without serological screening.
authors.affiliation: Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes 3900, 14049-900, Ribeirão Preto, SP, Brazil. propat@ig.com.br
authors.forename: Patricia Ribeiro
authors.initials: PR
authors.lastname: de Oliveira
authors.forename: Aparecida Yulie
authors.initials: AY
authors.lastname: Yamamoto
authors.forename: Cleonice Barbosa Sandoval
authors.initials: CB
authors.lastname: de Souza
authors.forename: Natalia Motta
authors.initials: NM
authors.lastname: de Araújo
authors.forename: Selma
authors.initials: S
authors.lastname: de Andrade Gomes
authors.forename: Anália Ribeiro
authors.initials: AR
authors.lastname: Heck
authors.forename: José Fernando
authors.initials: JF
authors.lastname: de Castro Figueiredo
authors.forename: Marisa Márcia
authors.initials: MM
authors.lastname: Mussi-Pinhata
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis*; D006514:Hepatitis B Surface Antigens / Q000302:isolation & purification*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008895:Milk, Human / Q000821:virology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens