Hepatitis B viral markers in banked human milk before and after Holder pasteurization.
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.
de Oliveira
Patricia Ribeiro
PR
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
Yamamoto
Aparecida Yulie
AY
de Souza
Cleonice Barbosa Sandoval
CB
de Araújo
Natalia Motta
NM
de Andrade Gomes
Selma
S
Heck
Anália Ribeiro
AR
de Castro Figueiredo
José Fernando
JF
Mussi-Pinhata
Marisa Márcia
MM
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
D015415:Biomarkers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens