There is increasing evidence of vertical transmission of HIV-1 to infants through breast feeding of milk from HIV-1 infected mothers. It has been postulated that transmission occurs mainly via ingestion of infected cells in breast milk and colostrum. In this study, detection of HIV-1 proviral DNA was used to prove that cells from colostrum and milk do contain HIV. DNA were extracted from these cells of colostrum and milk of 18 seropositive mothers and amplified by nested PCR for HIV-1 gag and pol and 44 per cent were positive mostly by two primers. All ten negative control samples from seronegative mothers were negative. This study demonstrated the infectivity of breast milk and colostrum. Nevertheless, recommendation against breast-feeding should be weighed against poor alternatives in low socioeconomic families.
PIP: In Thailand clinicians gathered breast milk and colostrum samples (1 ml) at 1-10 days postpartum from 18 HIV-1 seropositive mothers at Ramathibodi Hospital and Maharaj Hospital and from 10 HIV-1 seronegative mothers at the same hospitals. Researchers used polymerase chain reaction to detect HIV-1 proviral DNA in cells in the breast milk and colostrum. Breast milk and colostrum samples from 44% of the HIV-1 seropositive women tested positive for HIV-1 DNA. The pol primers were superior to the gag primers. All of the colostrum samples of the HIV-1 seronegative women tested negative. These results suggest that HIV-1 seropositive lactating mothers can transmit HIV-1 via breast feeding after childbirth. The Obstetrics and Gynaecology Department at Ramathibodi Hospital in Bangkok advises HIV-1 infected mothers to not breast feed if there is a suitable alternative available. Health professionals should weigh breast feeding against poor alternatives in impoverished families.