title: Breast milk HIV-1 RNA levels and female sex are associated with HIV-1-specific CD8+ T-cell responses in HIV-1-exposed, uninfected infants in Kenya.
abstract: BACKGROUND
  Although evidence supports a relationship between human immunodeficiency virus (HIV)-1 exposure and HIV-1-specific CD8(+) T cell responses, studies have not demonstrated a direct association between the quantity of HIV-1 to which a person is exposed and the presence or absence of a response.
  
  
  METHODS
  From 1999 to 2005, maternal HIV-1 RNA levels were measured in blood, cervical secretions, and breast milk at delivery and 1 month after delivery. HIV-1-specific interferon (IFN)-γ Elispot assays were conducted to determine infant CD8(+) T-cell responses at 3 months of age.
  
  
  RESULTS
  Among 161 infants tested with Elispot assays, 23 (14%) had positive results. Mothers whose infants had a positive assay had higher breast milk HIV-1 RNA levels at month 1 compared with mothers whose infants had negative Elispot assays (3.1 vs 2.5 log(10) copies/mL; P = .017). Female infants were also more likely to have positive Elispot assays than male infants (P = .046), and in multivariate analyses, both female sex and high breast milk HIV-1 levels remained important predictors of a positive response (P = .022 and P = .015, respectively).
  
  
  CONCLUSIONS
  Exposure to breast milk HIV-1 and sex were associated with development of HIV-1-specific CD8(+) T-cell responses in infants. These data support a role for mucosal exposure via the oral route in induction of systemic HIV-1-specific cellular immunity.
authors: Department of Medicine, University of Washington, Seattle 98104-2499, USA. cfarq@u.washington.edu
authors: Carey
authors: C
authors: Farquhar
authors: Barbara
authors: B
authors: Lohman-Payne
authors: Julie
authors: J
authors: Overbaugh
authors: Barbra A
authors: BA
authors: Richardson
authors: Jennifer
authors: J
authors: Mabuka
authors: Rose
authors: R
authors: Bosire
authors: Dorothy
authors: D
authors: Mbori-Ngacha
authors: Grace
authors: G
authors: John-Stewart
mesh_terms: D000328:Adult; D001942:Breast Feeding; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000635:transmission*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007371:Interferon-gamma / Q000097:blood; D007630:Kenya; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008895:Milk, Human / Q000737:chemistry / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis* / Q000097:blood; D012737:Sex Factors; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D012367:RNA, Viral; D007371:Interferon-gamma