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  • Title: Human milk and HIV infection: epidemiologic and laboratory data.
    Author: Davis MK.
    Journal: Adv Exp Med Biol; 1991; 310():271-80. PubMed ID: 1809004.
    Abstract:
    This review summarizes available case reports, epidemiological series, and laboratory studies on the extent of transmission of HIV to infants by breast feeding. There have been 8 case reports of infants who became infected with HIV after birth, whose mothers seroconverted postpartum, by contaminated blood transfusions, artificial insemination, iv drug use, or sexual contact, in Australia, France, Rwanda, and Zaire. Only a minority of the breast fed children of these women seroconverted to HIV positive. It is possible that the likelihood of transmission is higher when the mother is viremia soon after contracting HIV. There are 2 small prospective studies, one of 641 Zambian women, of whom 16 became HIV positive within 1 year postpartum. 2 of 8 of their breast fed children (25%) seroconverted before 24 months of age. In another series of 212 women from Rwanda, 16 women seroconverted, and 9 infants became HIV positive, of whom only 4 were probably infected from breast milk. Laboratory evidence for transmission of HIV includes isolation of HIV from 5 milk samples in 1985, 1 report of HIV in colostrum in 1986, and 1 report of HIV documented in milk by electron microscopy in 1988. A study of breast milk using the polymerase chain reaction method showed 71% of breast milk specimens from HIV-positive women contained HIV DNA. The 5 published reports of analysis of breast milk from HIV+ women for HIV antibodies found that 33%, 50%, 92%, 100%, and 100% respectively of the milk specimens had anti-HIV antibodies. Whether these antibodies are capable of blocking transmission of HIV to infants is unknown. Research on the potential for human milk and its anti-HIV antibodies to inactivate HIV virus is needed, as is information on the natural history of HIV infection in breast feeding mothers and their infants. It is also unknown if the nutritional and immunological quality of the milk of an HIV-infected woman is impaired.
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