Detection of human immunodeficiency virus type 1 (HIV-1) DNA and P24 antigen in breast milk of HIV-1 infected Ugandan women and vertical transmission

OBJECTIVE: To determine the correlation between the detection of human immunodeficiency virus type 1 (HIV-1) in breast milk; the duration of breastfeeding; and vertical transmission of HIV-1 infection in Ugandan women. METHODS: Aprospective study of HIV-1 infection in pregnant Ugandan women and their infants has been ongoing since 1990 with follow-up of mother-infant pairs for at least 2 years. Expressed breast milk specimens were collected from 201 HIV-1 seropositive and 86 HIV-1 seronegative Ugandan women approximately 6 weeks after delivery. The presence of HIV-1 DNA in the cellular fraction of the breast milk was detected by polymerase chain reaction (PCR); and HIV-1 p24 antigen was detected in the cell-free breast milk supernatant using p24 antigen enzyme immunoassay (EIA) after immune complex dissociation (ICD). The duration of breastfeeding and the clinic status of the mothers and their chidlren were recorded. HIV-1 ELIA; Western blot; PCR; or p24 antigen detection were used for the determination of the HIV-1 infection status of the children. RESULTS: Of the 201 HIV-1 infected women studied; 47 had HIV-1 infected children; 143 had children who seroverted; and 11 had children of indeterminate status. Breast milk supernatants were available for ICD p24 antigen testing from 188 of the HIV-1 infected women and none had detectable p24 antigen. Breast milk cell pellets were a vailable and contained amplifiable DNA in 125 of the HIV-i-infected women (20 transmitters; 104 nontransmitters; 1 indeterminante). HIV-1 DNA was detected by PCR in 72(75/104) of nontransmitters and 80(16/20) of the transmitters. The duration of breastfeeding by transmitter mothers (15.8 months) was not significantly different from nontransmitter mothers (14.4 months). CONCLUSIONS: No correlation was found between the detection of HIV-1 in breast milk or the duration of breasfeeding and transmission of HIV-1 infection in this study of Ugandan women

HIV-1 seroprevalence rates in women attending prenatal clinics in Kampala; Uganda

The objective was to determine the HIV-1 seroprevalence in expectant women in Kampala. HIV-1 antibody status (by ELISA -Cambridge Biotech; with comformatory ELISA-Wellcozyme on positives); obstetric and socio-demographic characteristics were determined on a random proportionate to-size sample of 1002 expectant consenting women seeking care at 11 prenatal units in Kampala between august and December of 1993. HIV-1 age-specific rates were determined. Chi-square analysis; tests for linear trend in rates and 95CI were used to determine significance of seroprevalence rates. Results showed overall seroprevalence of HIV-1 for the study population (mean age = 22.4 years; range = 14 - 42 years) was 20.5(95CI:18.0; 23.1); with the highest age-specific rate of 28.55 occurring at 20 - 22 years. An increasing trend of rates was observed between 14 - 24 years (p0.0001); followed; thereafter; by a decreasing trend (p

Non-isotopic polymerase chain reaction methods for the detection of HIV-1 in Ugandan mothers and infants

Two non-isotopic polymerase chain reaction (PCR) methods were evaluated by testing blood from 41 HIV-1-seropositive and 16 HIV-1 seronegative Ugandan mothers and 56 of their children (aged 0.5- 15.0 months). Amplification of HIV-1 sequences was performed in duplicate using a biotinylated primer pair to the gag region (SK 462-431) and nested primer pairs (JA 17-20) to the pol region of HIV-1. gag sequences were hybridized using a microtiter plate coated with the SK 102 probe followed by colorimetric detection using an avidin-horseradish peroxidase conjugate and tetramethylbenzidine/peroxide substrate. Pol sequences were detected on angarose gel stained with ethidium bromide. Results of HIV-1 PCR analysis showed that 40 out of 41 (98) seropositive mothers and 10 out of 29 (34) seropositive or Western blot-indeterminate children had detectable HIV-1 sequences. Our results suggest that non-isotopic PCR methods are sensitive; specific; and potentially useful in the early diagnosis of HIV-1 infection in developed and developing countries

Non-isotopic polymerase chain reaction methods for the detection of HIV-1 in Ugandan mothers and infants

Two non-isotopic polymerase chain reaction (PCR) methods were evaluated by testing blood from 41 HIV-1-seropositive and 16 HIV-1-seronegative Ugandan mothers and 56 of their children (aged 0.5-15.0 months). Amplification of HIV-1 sequences was performed in duplicate using a biotinylated primer pair to the gag region (SK 462-431) and nested primer pairs (JA 17-20) to the pol region of HIV-1. gag sequences were hybridized using a microtiter plate coated with the SK 102 probe followed by colorimetric detection using an avidin-horseradish peroxidase conjugate and tetramethylbenzidine/peroxide substrate. pol sequences were detected on agarose gel stained with ethidium bromide. Results of HIV-1 PCR analysis showed that 40 out of 41 (98pc) seropositive mothers and 10 out of 29 (34pc) seropositive children had detectable HIV-1 gag and pol sequences. None of the 16 seronegative mothers nor 27 seronegative or Western blot-indeterminate children had detectable HIV-1 sequences. Our results suggest that non-isotopic PCR methods are sensitive; specific; and potentially useful in the early diagnosis of HIV-1 infection in developed and developing countries

Mother to Child HIV Transmission

Mother-to-Child Human Immunodeficiency Virus (HIV) Transmission is the largest source of HIV infection among children below 15 years of age. On a global scale; children are being infected at the rate of one child every minute of everyday. World Health Organisation estimated that 600;000 children World Wide were born with HIV infection in 1999 of whom 90were born to mothers from Sub-Saharan Africa. Babies acquire the virus during pregnancy; in labour (the vast majority of cases) and during breastfeeding. The possibility of a baby born to HIV infected mother acquiring HIV infecvtion is 15-25in developed countries and 25-45in developing countries. This difference is accounted for by a number of factors including breastfeeding and nutrition. HIV infection is a fatal disease with no apparent cure. If left unchecked; it is bound to abolish all the gains in child survival registered through the Expanded Programme on Immunization (EPI) in Africa. Up to recent years; Primary HIV prevention and use of contraceptives to stop infected women becoming pregnant have been the only means for prevention of Mother to Child HIV transmission (MTCT). With better understanding of the mechanism and methods of Mother to Child HIV transmission; more and better scientific methods of prevention of Mother to Child HIV Transmission have been developed. The future generation of children could be protected from HIV infection with rapid implementation of effective; economical and simple strategies for prevention of MTCT

HIV-1 seroprevalence rates in women attending prenatal clinics in Kampala; Uganda. (p.96)

The objective was to determine the HIV-1 seroprevalence in expectant women in Kampala. HIV-1 antibody status (by ELISA -Cambridge Biotech; with comformatory ELISA-Wellcozyme on positives); obstetric and socio-demographic characteristics were determined on a random proportionate to-size sample of 1002 expectant consenting women seeking care at 11 prenatal units in Kampala between august and December of 1993. HIV-1 age-specific rates were determined. Chi-square analysis; tests for linear trend in rates and 95CI were used to determine significance of seroprevalence rates. Results showed overall seroprevalence of HIV-1 for the study population (mean age