Flash-Heat Inactivation of HIV-1 in Human Milk: A Potential Method to Reduce Postnatal Transmission in Developing Countries
June 4, 2007
"Up to 40% of all mother-to-child transmission of HIV occurs by means of breast-feeding; yet, in developing countries, infant formula may not be a safe option," the authors wrote. Noting that the World Health Organization recommends heat-treated breast milk as an infant-feeding alternative, they investigated the ability of flash-heat to inactivate HIV in breast milk from HIV-positive mothers.
The researchers collected 98 breast milk samples from 84 HIV-positive mothers in a periurban settlement in South Africa. The samples were aliquoted to flash-heating or unheated (control). To differentiate between active and inactivated cell-free HIV in the samples, reverse transcriptase (RT) assays (lower detection limit of 400 HIV copies/mL) were performed.
Detectable HIV was found in the milk of 26 of 84 mothers (31 percent). Multivariate logistic regression, after adjusting for covariates, showed a statistically significant negative association between detectable virus in breast milk and maternal CD4+T-lymphocyte count (P=0.045) and volume of breast milk expressed (P=0.01) and a positive association with use of multivitamins (P=0.03). In the RT assay, all the flash-heated samples showed undetectable levels of cell-free HIV-1 (P"Flash-heat can inactivate HIV in naturally infected breast milk from HIV-positive women," the authors concluded. "Field studies are urgently needed to determine the feasibility of in-home flash-heating breast milk to improve infant health while reducing postnatal transmission of HIV in developing countries."
Journal of Acquired Immune Deficiency Syndromes
05.17.07; doi: 10.1097/QAI.0b013e318074eeca; Kiersten Israel-Ballard, M.P.H.; Richard Donovan, Ph.D.; Caroline Chantry, M.D.; Ann Coutsoudis, Ph.D.; Haynes Sheppard, Ph.D.; Lindiwe Sibeko, M.Sc.; Barbara Abrams, Dr.P.H.