ABSTRACT
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
Subject(s)
Breast Feeding , HIV Infections , Women's HealthABSTRACT
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