Israel-Ballard Kiersten, Donovan Richard, Chantry Caroline, Coutsoudis Anna, Sheppard Haynes, Sibeko Lindiwe, Abrams Barbara
Division of Epidemiology, School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):318-23. doi: 10.1097/QAI.0b013e318074eeca.
Up to 40% of all mother-to-child transmission of HIV occurs by means of breast-feeding; yet, in developing countries, infant formula may not be a safe option. The World Health Organization recommends heat-treated breast milk as an infant-feeding alternative. We investigated the ability of a simple method, flash-heat, to inactivate HIV in breast milk from HIV-positive mothers.
Ninety-eight breast milk samples, collected from 84 HIV-positive mothers in a periurban settlement in South Africa, were aliquoted to unheated control and flash-heating. Reverse transcriptase (RT) assays (lower detection limit of 400 HIV copies/mL) were performed to differentiate active versus inactivated cell-free HIV in unheated and flash-heated samples.
We found detectable HIV in breast milk samples from 31% (26 of 84) of mothers. After adjusting for covariates, multivariate logistic regression showed a statistically significant negative association between detectable virus in breast milk and maternal CD4+ T-lymphocyte count (P=0.045) and volume of breast milk expressed (P=0.01) and a positive association with use of multivitamins (P=0.03). All flash-heated samples showed undetectable levels of cell-free HIV-1 as detected by the RT assay (P<0.00001).
Flash-heat can inactivate HIV in naturally infected breast milk from HIV-positive women. Field studies are urgently needed to determine the feasibility of in-home flash-heating breast milk to improve infant health while reducing postnatal transmission of HIV in developing countries.
高达40%的母婴传播艾滋病毒是通过母乳喂养发生的；然而，在发展中国家，婴儿配方奶粉可能不是一个安全的选择。世界卫生组织建议将经过热处理的母乳作为一种婴儿喂养替代品。我们研究了一种简单的方法——快速加热，使艾滋病毒阳性母亲的母乳中的艾滋病毒失活的能力。
从南非一个城郊定居点的84名艾滋病毒阳性母亲那里收集了98份母乳样本，将其分成未加热的对照组和快速加热组。进行逆转录酶（RT）检测（检测下限为每毫升400个艾滋病毒拷贝），以区分未加热和快速加热样本中活性与失活的游离艾滋病毒。
我们在31%（84名中的26名）母亲的母乳样本中检测到了可检测到的艾滋病毒。在对协变量进行调整后，多变量逻辑回归显示，母乳中可检测到的病毒与母亲的CD4 + T淋巴细胞计数（P = 0.045）和挤出的母乳量（P = 0.01）之间存在统计学上显著的负相关，与使用多种维生素之间存在正相关（P = 0.03）。所有快速加热的样本通过RT检测均显示未检测到游离的HIV-1水平（P < 0.00001）。
快速加热可以使艾滋病毒阳性女性自然感染的母乳中的艾滋病毒失活。迫切需要进行现场研究，以确定在家庭中对母乳进行快速加热的可行性，从而在改善发展中国家婴儿健康的同时减少艾滋病毒的产后传播。
