Original article
English
Ramalingam R 1, Mathew SN 2, Saramini MJ 2, Murthy Bombay Narashima MB 3, Daniel K 4, Jager H 5
1-Al-Goemail Medical College, Department of Microbiology, Faculty of Medicine, 7thApril University, Zawia, Libya. 2-Department of Experimental Medicine & AIDS Research Center, Medical University, Chennai, India. 3-National Institute of Epidemiology, Tuberculosis Research Center, Chennai, India. 4-Raja Sir Ramasamy Memorial Hospital, Chennai, India. 5-Curatorium for Immunodificiency, (KIS) Munich, Germany.
Libyan J Infect Dis. 2009;3(1):37-43
Abstract
Objectives: The aim of the study was to estimate the levels of Cell free virus (CFV) HIV-1 RNA in plasma and breast milk of lactating HIV seropositive mothers who received single dose Nevirapine (NVP) as antiretroviral prophylaxis and to analyze the HIV-1 transmission through breastfeeding.
Methods: A cohort of fifty HIV seropositive mothers who received single dose nevirapine at labor and delivered in Raja Sir Ramasamy Memorial Hospital in Chennai India from November 2002 to March 2005 were enrolled. The breast milk and plasma samples were measured for CFV by Roche COBAS Amplicor monitor test. These samples were collected at 4 time points (100X4=400) (first day, 2, 4 and 6 months after delivery). The infant whole blood was analysed for HIV-1 DNA PCR at 6 time points (50X6=300) (at birth, 2, 4, 6, 12 and 18 months).
Results: The mean CFV load was higher in plasma and breast milk for mothers with HIV positive infants than in mothers with HIV negative infants at first day (4.82log 10 vs 3.81; p<0.01), 4.84 vs 3.79; p<0.01 at 2nd month, 4.84 vs 3.81; p<0.01) at 4th months and 4.84 vs 3.68; p<0.01 at 6th months. The mean CFV load was significantly higher in colostrums (711 vs 496; p< 0.01) than in mature breast milk. Three (6%) of the infants were HIV-1 positive at birth and one infant was negative at birth but was found to be positive by 2 months of age. This may be postnatal infection.
Conclusion: Our data from small cohort of HIV infected women suggest that mothers with high levels of CFV in their plasma and breast milk up to 6 months were more likely to transmit HIV-1 through breastfeeding.
Keywords: Viral load, HIV breastmilk, Transmission.
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