Chantry C J, Morrison P, Panchula J, Rivera C, Hillyer G, Zorilla C, Diaz C
Department of Pediatrics, University of California Davis, Sacramento, California, USA.
J Acquir Immune Defic Syndr. 2000 Aug 1;24(4):325-9. doi: 10.1097/00126334-200008010-00005.
Transmission of HIV-1 infection through breastfeeding is associated with integrated DNA (provirus) in milk cells. Reduction of HIV-1 DNA in milk may lessen infectivity.
To investigate efficacy of two methods available in developing countries to reduce HIV-1 proviral DNA in breast milk.
Methods simulated field conditions; milk was heated by bringing it to a boil, for instance, over a cooking fire, and lipolysis was done at room temperature. Four HIV-positive pregnant women were recruited for this pilot study, instructed to feed formula exclusively, and to stimulate milk production using pumping. Milk was collected twice weekly for 3 weeks and analyzed qualitatively for HIV-1 proviral DNA by polymerase chain reaction at three stages: 1) fresh, 2) after standing for 6 hours, and 3) after having been brought to the boiling point.
Seventeen samples from 4 mothers were analyzed. Fifteen of 17 fresh samples (88%) had measurable HIV-1 proviral DNA despite all mothers' having had low or undetectable plasma viral loads. Lipolysis (standing at room temperature) for 6 hours did not destroy proviral DNA: 6 of 7 samples (86%) tested positive for DNA after lipolysis. No samples of milk (n = 8) brought to a boil were positive for HIV-1 proviral DNA (p <.0001).
This preliminary evidence suggests that inherent lipolytic activity of fresh breast milk is inadequate for destruction of HIV-1; bringing breast milk to a boil may result in decreased HIV-1 infectivity; and breast milk cell-associated HIV-1 may not reflect plasma viral load. Nutritional value or possible bacterial contamination of milk treated in this manner was not assessed.
通过母乳喂养传播HIV-1感染与乳汁细胞中的整合DNA（前病毒）有关。降低乳汁中的HIV-1 DNA可能会降低传染性。
研究发展中国家可用的两种方法降低母乳中HIV-1前病毒DNA的效果。
方法模拟现场条件；例如，通过在炊火上煮沸来加热乳汁，并在室温下进行脂肪分解。招募了4名HIV阳性孕妇进行这项初步研究，指导她们仅用配方奶喂养，并使用吸奶器刺激乳汁分泌。每周收集两次乳汁，持续3周，并在三个阶段通过聚合酶链反应对HIV-1前病毒DNA进行定性分析：1）新鲜乳汁，2）静置6小时后，3）煮沸后。
分析了来自4位母亲的17份样本。尽管所有母亲的血浆病毒载量都很低或检测不到，但17份新鲜样本中有15份（88%）检测到可测量的HIV-1前病毒DNA。脂肪分解（在室温下静置）6小时并未破坏前病毒DNA：7份样本中有6份（86%）在脂肪分解后DNA检测呈阳性。8份煮沸的乳汁样本中没有一份HIV-1前病毒DNA呈阳性（p<.0001）。
这一初步证据表明，新鲜母乳固有的脂肪分解活性不足以破坏HIV-1；将母乳煮沸可能会降低HIV-1的传染性；与母乳细胞相关的HIV-1可能无法反映血浆病毒载量。未评估以这种方式处理的乳汁的营养价值或可能的细菌污染情况。
