Document Detail


Human milk oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding.
MedLine Citation:
PMID:  22894939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The inefficiency of HIV breast-milk transmission may be caused by the presence of immunologically active factors, including human milk oligosaccharides (HMOs).
OBJECTIVE: We investigated whether HMO concentrations are associated with a reduced risk of postnatal HIV transmission.
DESIGN: A nested case-control study was conducted within a larger cohort study of HIV-infected women and their infants followed from birth to 24 mo in Lusaka, Zambia. Breast-milk samples collected at 1 mo from 81 HIV-infected women who transmitted via breastfeeding, a random sample of 86 HIV-infected women who did not transmit despite breastfeeding, and 36 uninfected breastfeeding women were selected. Total and specific HMO concentrations were measured by HPLC and compared between groups with adjustment for confounders by using logistic regression.
RESULTS: HIV-infected women with total HMOs above the median (1.87 g/L) were less likely to transmit via breastfeeding (OR: 0.45; 95% CI: 0.21, 0.97; P = 0.04) after adjustment for CD4 count and breast-milk HIV RNA concentrations; a trend toward higher concentrations of lacto-N-neotetraose being associated with reduced transmission (OR: 0.49; 95% CI: 0.23, 1.04; P = 0.06) was also observed. The proportion of 3'-sialyllactose (3'-SL) per total HMOs was higher among transmitting than among nontransmitting women (P = 0.003) and correlated with higher plasma and breast-milk HIV RNA and lower CD4 counts. Neither Secretor nor Lewis status distinguished between transmitting and nontransmitting women.
CONCLUSIONS: Higher concentrations of non-3'-SL HMOs were associated with protection against postnatal HIV transmission independent of other known risk factors. Further study of these novel, potentially anti-HIV components of breast milk is warranted.
Authors:
Lars Bode; Louise Kuhn; Hae-Young Kim; Lauren Hsiao; Caroline Nissan; Moses Sinkala; Chipepo Kankasa; Mwiya Mwiya; Donald M Thea; Grace M Aldrovandi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-08-15
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  96     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-21     Completed Date:  2012-12-07     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  831-9     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00310726
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MeSH Terms
Descriptor/Qualifier:
Adult
Breast Feeding*
CD4 Lymphocyte Count
Case-Control Studies
Cohort Studies
Confounding Factors (Epidemiology)
Female
HIV / pathogenicity*
HIV Infections / blood,  epidemiology,  transmission*
Humans
Infant
Infant, Newborn
Lewis Blood-Group System / metabolism
Male
Milk, Human / chemistry*,  secretion,  virology*
Oligosaccharides / analysis*,  secretion
RNA, Viral / analysis,  blood
Risk
Young Adult
Zambia / epidemiology
Grant Support
ID/Acronym/Agency:
DE021238/DE/NIDCR NIH HHS; HD39611/HD/NICHD NIH HHS; HD40777/HD/NICHD NIH HHS; HD57617/HD/NICHD NIH HHS; P30 AI036214/AI/NIAID NIH HHS; R01 DE021238/DE/NIDCR NIH HHS
Chemical
Reg. No./Substance:
0/3'-sialyllactose; 0/Lewis Blood-Group System; 0/Oligosaccharides; 0/RNA, Viral; 13007-32-4/lacto-N-neotetraose
Comments/Corrections

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


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