Cell-free human immunodeficiency virus type 1 in breast milk

Abstract

Breast-feeding may be an important route of human immunodeficiency virus type 1 (HIV-1) vertical transmission in settings where it is routinely practiced. To define the prevalence and quantity of HIV-1 in cell-free breast milk, samples from HIV-1–seropositive women were analyzed by quanti-tative competitive reverse transcription–polymerase chain reaction (QC-RT-PCR). HIV-1 RNA was detected in 29 (39%) of 75 specimens tested. Of these 29 specimens, 16 (55%) had levels that were near the detection limit of the assay (240 copies/mL), while 6 (21%) had 900 copies/mL. The maximum concentration of HIV-1 RNA detected was 8100 copies/mL. The prevalence of cell-free HIV-1 was higher in mature milk (47%) than in colostrum (27%, P 0.1). Because mature milk is consumed in large quantities, these data suggest that cell-free HIV-1 in breast milk may contribute to vertical transmission of HIV-1. Breast-feeding is associated with lower infant morbidity and ble benefits of other methods of infant feeding. The risk of HIV-1 vertical transmission in breast-feeding compared with formula-mortality than is formula-feeding and is the recommended form of infant feeding worldwide [1]. After the onset of the human feeding mother-infant pairs has been difficult to determine be-cause in most populations a single form of feeding predominates.immunodeficiency virus type 1 (HIV-1) pandemic, the possibil-ity of vertical transmission through breast-feeding raised con- A metanalysis of six studies involving women with establishe