Document Detail


Dynamics of breast milk HIV-1 RNA with unilateral mastitis or abscess.
MedLine Citation:
PMID:  23202812     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mastitis and abscess in HIV-infected women increase the risk of breastfeeding transmission of HIV. Guidelines encourage women to stop breastfeeding on the affected breast and feed on the contralateral breast. However, impact of breast pathology on breast milk HIV dynamics is unknown.
METHODS: HIV RNA was quantified in 211 breast milk samples collected before, during, and after a clinical mastitis or an abscess diagnosis from 38 HIV-infected women participating in a Zambian breastfeeding study. HIV RNA quantity was compared between affected and unaffected breasts over time using generalized estimating equation models. A sample of 115 women without breast pathology was selected as a control group.
RESULTS: In the affected breast, breast milk HIV RNA quantity increased from the pre- to during-pathology period by log(10) 0.45 copies per milliliter [95% confidence interval (CI): 0.16 to 0.74], and after symptom resolution, HIV RNA levels were no different from prepathology levels (log10 -0.04 copies per milliliter 95% CI: -0.33 to 0.25). In the contralateral, unaffected breast, HIV RNA quantity did not significantly increase (log(10) 0.15 copies per milliliter, 95% CI: -0.41 to 0.10). Increase was more marked in women with abscess or with a greater number of mastitis symptoms. HIV RNA was not significantly different between affected and unaffected women, except at the time of diagnosis.
CONCLUSIONS: Breast milk HIV RNA increased modestly in the affected breast with unilateral mastitis or abscess and returned to prepathology levels with symptom resolution. Contralateral HIV RNA was not affected. Results support guidelines encouraging feeding from the contralateral breast to minimize the risk of HIV transmission associated with unilateral breast pathology.
Authors:
Katherine Semrau; Louise Kuhn; Daniel R Brooks; Howard Cabral; Moses Sinkala; Chipepo Kankasa; Donald M Thea; Grace M Aldrovandi
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-08-08     Completed Date:  2013-08-20     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  348-55     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Abscess / virology*
Adult
Breast Diseases / virology*
Breast Feeding / adverse effects
Female
HIV Infections / transmission,  virology*
HIV-1*
Humans
Mastitis / virology
Milk, Human / virology*
Polymerase Chain Reaction
RNA, Viral / analysis*
Grant Support
ID/Acronym/Agency:
R01 HD 39611/HD/NICHD NIH HHS; R01 HD 40777/HD/NICHD NIH HHS; R01 HD039611/HD/NICHD NIH HHS; R01 HD040777/HD/NICHD NIH HHS; R01 HD057617/HD/NICHD NIH HHS; R01 HD057617/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/RNA, Viral
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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