The University of Southampton
University of Southampton Institutional Repository

Cytomegalovirus, and possibly Epstein-Barr virus, shedding in breast milk is associated with HIV-1 transmission by breastfeeding

Cytomegalovirus, and possibly Epstein-Barr virus, shedding in breast milk is associated with HIV-1 transmission by breastfeeding
Cytomegalovirus, and possibly Epstein-Barr virus, shedding in breast milk is associated with HIV-1 transmission by breastfeeding
Objective: postnatal HIV-1 mother-to-child transmission (MTCT) occurs in spite of antiretroviral therapy. Co-infections in breast milk with cytomegalovirus (CMV) and Epstein–Barr virus (EBV) are associated with increased HIV-1 shedding in this compartment. We investigated CMV levels and EBV detection in breast milk as potential risk factors for MTCT of HIV-1 via breastfeeding.

Methods: cell-free HIV-1 RNA, cell-associated HIV-1 DNA, CMV and EBV DNA were quantified in breast milk from 62 HIV-infected mothers and proven postnatal MTCT of HIV-1 via breastfeeding. Controls were 62 HIV-positive mothers with HIV-uninfected infants.

Results: median (interquartile range) CMV DNA viral load was significantly higher in cases [88?044 (18?586–233?904)] than in controls [11?167 (3221–31?152)]?copies/106 breast milk cells (P?<?0.001). Breast milk CMV DNA level correlated positively with breast milk HIV-1 RNA level in cases and controls. EBV DNA was detectable in a higher proportion of breast milk samples of cases (37.1%) than controls (16.1%; P?=?0.009). HIV-1 MTCT was strongly associated with HIV-1 RNA shedding in breast milk and plasma. In multivariable analysis, every 1 log10 increase in breast milk CMV DNA was associated with a significant 2.5-fold greater odds of MTCT of HIV-1, independent of breast milk and plasma HIV-1 levels; the nearly three-fold increased risk of HIV-1 MTCT with breast milk EBV DNA detection did not reach significance.

Conclusion: we provide the first evidence of an independent association between CMV in breast milk, and postnatal MTCT of HIV-1. This association could fuel persistent shedding of HIV-1 in breast milk in women receiving antiretroviral therapy. EBV DNA detection in breast milk may also be associated with MTCT of HIV-1, but only marginally so
145-153
Viljoen, J.
a15f94c4-dc7e-4cc3-be82-352ca816d447
Tuaillon, E.
25b18981-72b9-41a8-a991-017b74bc7ae1
Nagot, N.
b32bc029-8006-4063-8ed4-b668b02d4b86
Danaviah, S.
3bc2faab-ef64-4d58-8136-f36f5a453c4e
Peries, M.
e0a67be2-f683-4c4f-8349-b51d3c826090
Padayachee, P.
6e71e6c7-2583-48ee-a26e-76db9d3ba9f0
Foulongne, V.
0bfb5af0-a7a5-48cf-a5b6-b79b3c0fe8d1
Bland, R.
2bcd54ae-a1ee-4dda-85bc-bb43facbcb5a
Rollins, N.
3ad6d4e9-9f74-428d-b399-2a498e1fbf60
Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
van de Perre, P.
e71f8816-fad7-47ce-9b1b-0ab980dadfb7
Viljoen, J.
a15f94c4-dc7e-4cc3-be82-352ca816d447
Tuaillon, E.
25b18981-72b9-41a8-a991-017b74bc7ae1
Nagot, N.
b32bc029-8006-4063-8ed4-b668b02d4b86
Danaviah, S.
3bc2faab-ef64-4d58-8136-f36f5a453c4e
Peries, M.
e0a67be2-f683-4c4f-8349-b51d3c826090
Padayachee, P.
6e71e6c7-2583-48ee-a26e-76db9d3ba9f0
Foulongne, V.
0bfb5af0-a7a5-48cf-a5b6-b79b3c0fe8d1
Bland, R.
2bcd54ae-a1ee-4dda-85bc-bb43facbcb5a
Rollins, N.
3ad6d4e9-9f74-428d-b399-2a498e1fbf60
Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
van de Perre, P.
e71f8816-fad7-47ce-9b1b-0ab980dadfb7

Viljoen, J., Tuaillon, E., Nagot, N., Danaviah, S., Peries, M., Padayachee, P., Foulongne, V., Bland, R., Rollins, N., Newell, M.L. and van de Perre, P. (2015) Cytomegalovirus, and possibly Epstein-Barr virus, shedding in breast milk is associated with HIV-1 transmission by breastfeeding. AIDS, 29, 145-153. (doi:10.1097/QAD.0000000000000527).

Record type: Article

Abstract

Objective: postnatal HIV-1 mother-to-child transmission (MTCT) occurs in spite of antiretroviral therapy. Co-infections in breast milk with cytomegalovirus (CMV) and Epstein–Barr virus (EBV) are associated with increased HIV-1 shedding in this compartment. We investigated CMV levels and EBV detection in breast milk as potential risk factors for MTCT of HIV-1 via breastfeeding.

Methods: cell-free HIV-1 RNA, cell-associated HIV-1 DNA, CMV and EBV DNA were quantified in breast milk from 62 HIV-infected mothers and proven postnatal MTCT of HIV-1 via breastfeeding. Controls were 62 HIV-positive mothers with HIV-uninfected infants.

Results: median (interquartile range) CMV DNA viral load was significantly higher in cases [88?044 (18?586–233?904)] than in controls [11?167 (3221–31?152)]?copies/106 breast milk cells (P?<?0.001). Breast milk CMV DNA level correlated positively with breast milk HIV-1 RNA level in cases and controls. EBV DNA was detectable in a higher proportion of breast milk samples of cases (37.1%) than controls (16.1%; P?=?0.009). HIV-1 MTCT was strongly associated with HIV-1 RNA shedding in breast milk and plasma. In multivariable analysis, every 1 log10 increase in breast milk CMV DNA was associated with a significant 2.5-fold greater odds of MTCT of HIV-1, independent of breast milk and plasma HIV-1 levels; the nearly three-fold increased risk of HIV-1 MTCT with breast milk EBV DNA detection did not reach significance.

Conclusion: we provide the first evidence of an independent association between CMV in breast milk, and postnatal MTCT of HIV-1. This association could fuel persistent shedding of HIV-1 in breast milk in women receiving antiretroviral therapy. EBV DNA detection in breast milk may also be associated with MTCT of HIV-1, but only marginally so

Text
Viljoen J AIDS 2015.pdf - Version of Record
Restricted to Repository staff only
Request a copy

More information

Published date: January 2015
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 379608
URI: http://eprints.soton.ac.uk/id/eprint/379608
PURE UUID: 3d1086b0-9718-43dc-ad8c-c5e68d5c61ba
ORCID for M.L. Newell: ORCID iD orcid.org/0000-0002-1074-7699

Catalogue record

Date deposited: 06 Aug 2015 09:20
Last modified: 24 Sep 2019 00:36

Export record

Altmetrics

Contributors

Author: J. Viljoen
Author: E. Tuaillon
Author: N. Nagot
Author: S. Danaviah
Author: M. Peries
Author: P. Padayachee
Author: V. Foulongne
Author: R. Bland
Author: N. Rollins
Author: M.L. Newell ORCID iD
Author: P. van de Perre

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×