Low and undetectable breast milk interleukin-7 concentrations are associated with reduced risk of postnatal HIV transmission.
Low and undetectable breast milk interleukin-7 concentrations are associated with reduced risk of postnatal HIV transmission.
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母乳中白细胞介素 7 浓度低且检测不到，与产后 HIV 传播风险降低相关。
DOI：
10.1097/qai.0b013e318141f942
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Aldrovandi,GraceM
中科院分区：
文献类型：
--
作者：
Walter,Jan;Kuhn,Louise;Ghosh,MrinalK;Kankasa,Chipepo;Semrau,Katherine;Sinkala,Moses;Mwiya,Mwiya;Thea,DonaldM;Aldrovandi,GraceM
Objective:To investigate if breast milk interleukin [IL]-7 concentrations are associated with postnatal HIV transmission.Design:A case-control study nested within a cohort of women recruited in Lusaka, Zambia.Methods:IL-7 breast milk concentrations were measured in samples from 24 HIV-infected breast-feeding women who transmitted HIV to their child after the neonatal period and from 47 women who did not transmit. Samples were frequency-matched by the time of sample collection (1 week and 1 month postpartum). Logistic regression was used to adjust for possible confounders. For comparison, samples from 18 HIV-uninfected women from the same community were included in the analysis, and plasma IL-7 was determined.Results:Breast milk IL-7 concentrations were significantly higher than plasma IL-7 concentrations in all 3 groups. In contrast to levels among transmitters and HIV-uninfected women, breast milk IL-7 concentrations exhibited a bimodal distribution among nontransmitters. Breast milk IL-7 concentrations undetectable or less than 30 pg/mL were significantly associated with less HIV transmission (odds ratio= 0.13, 95% confidence interval: 0.03 to 0.64). The association remained strong after adjustment for breast milk viral load and sodium, maternal CD4 cell counts, parity, and time of sample collection.Conclusion:Breast milk IL-7 may be necessary for effective HIV transmission.Breast-fed infants of HIV-infected mothers consume large quantities of HIV, 1 but most remain uninfected. 2 The mechanisms that may protect these breast-fed infants are not yet well understood. Risk factors for breast-feeding transmission include high cell-free and cell-associated breast milk viral load, 3-5 maternal immune status, 6 and behavioral factors such as duration of feeding 2 and mixed versus exclusive feeding. 7 Immunomodulating factors in breast milk such as HIV-specific antibodies, 8 cytotoxic T cells, 9 anti-infective factors, 10 and certain chemokines 11 have been found to influence the risk of HIV transmission further in some studies.
