title: Infant feeding practices were not associated with breast milk HIV-1 RNA levels in a randomized clinical trial in Botswana.
abstract: Exclusive breastfeeding has been associated with a reduced risk of late vertical HIV transmission as compared to an infant diet composed of breast milk mixed with supplemental foods or liquids. Hypothesized mechanisms include increased infectivity of breast milk from mothers who practice mixed breastfeeding (MBF), or mechanisms such as increased gastrointestinal permeability in the infant caused by mixed feeding. It has been proposed that MBF may result in subclinical mastitis and higher breast milk HIV titers. However, little is known about the relationship between feeding strategy and breast milk viral load. We measured the HIV-1 concentration in breast milk in a sub-cohort of women enrolled in a mother-to-child HIV transmission prevention trial (the "Mashi" study). We report no observed relationship between MBF and measured breast milk viral RNA load. Our findings suggest that the increased transmission risk associated with higher breast milk HIV-1 RNA during MBF is unlikely.
authors: Botswana-Harvard AIDS Institute, Gaborone, Botswana.
authors: Raabya
authors: R
authors: Rossenkhan
authors: Vladimir
authors: V
authors: Novitsky
authors: Teresa K
authors: TK
authors: Sebunya
authors: Jean
authors: J
authors: Leidner
authors: Jose E
authors: JE
authors: Hagan
authors: Sikhulile
authors: S
authors: Moyo
authors: Laura
authors: L
authors: Smeaton
authors: Shahin
authors: S
authors: Lockman
authors: Rosemary
authors: R
authors: Musonda
authors: Thumbi
authors: T
authors: Ndung'u
authors: Simani
authors: S
authors: Gaseitsiwe
authors: Ibou
authors: I
authors: Thior
authors: Mompati
authors: M
authors: Mmalane
authors: Joseph
authors: J
authors: Makhema
authors: M
authors: M
authors: Essex
authors: Roger
authors: R
authors: Shapiro
mesh_terms: D000328:Adult; D001902:Botswana / Q000453:epidemiology; D001942:Breast Feeding; D015331:Cohort Studies; D005260:Female; D006679:HIV Seropositivity / Q000635:transmission* / Q000821:virology; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008413:Mastitis / Q000453:epidemiology / Q000517:prevention & control*; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy; D012367:RNA, Viral / Q000032:analysis*; D019562:Viral Load
chemical_list: D012367:RNA, Viral