Journal article
Role of Intestinal Mucosal Integrity in HIV Transmission to Infants Through Breast-feeding: The BAN Study
The Journal of infectious diseases, Vol.208(4), pp.653-661
08/15/2013
DOI: 10.1093/infdis/jit221
PMCID: PMC3719904
PMID: 23687226
Abstract
Background. Increased intestinal permeability may be one of the mechanisms of transmission of human immunodeficiency virus (HIV) to infants through breast-feeding. Intestinal permeability correlates with microbial translocation, which can be measured through quantification of bacterial lipopolysaccharide (LPS).
Methods. We evaluated levels of plasma LPS (by the Limulus amebocyte lysate assay) and immune activation markers in serial specimens from infants exposed to but uninfected with HIV and infants infected with HIV from the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study.
Results. Plasma LPS levels increased after infants in the BAN study were weaned from the breast, at 24 weeks of age. Cotrimoxazole prophylaxis was associated with higher plasma LPS levels (P = .004). Infants with HIV infection had higher LPS levels, compared with uninfected infants (P = .004). Higher preinfection plasma LPS levels were a significant predictor of infant HIV infection through breast-feeding (hazard ratio = 1.60 for every unit increase in plasma LPS level; P = .01) and of lower infant length-for-age z scores (P = .02).
Conclusions. These findings suggest that disruption in intestinal integrity is a mechanism of HIV transmission to infants through breast-feeding. Weaning from breast milk and use of antibiotic prophylaxis was associated with increased levels of microbial translocation, which could facilitate HIV entry through the intestine. Complementary approaches to enhance intestinal mucosal integrity in the infant may further reduce breast-feeding transmission of HIV.
Details
- Title: Subtitle
- Role of Intestinal Mucosal Integrity in HIV Transmission to Infants Through Breast-feeding: The BAN Study
- Creators
- Athena P. Kourtis - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHP, Atlanta, GA 30333 USAChris C. Ibegbu - Emory UniversityJeffrey Wiener - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHP, Atlanta, GA 30333 USACaroline C. King - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHP, Atlanta, GA 30333 USAGerald Tegha - UNC Project Malawi, Lilongwe, MalawiDeborah Kamwendo - UNC Project Malawi, Lilongwe, MalawiJacob Kumwenda - UNC Project Malawi, Lilongwe, MalawiSurinder P. Kaur - Emory UniversityValerie Flax - Univ N Carolina, Chapel Hill, NC USASascha Ellington - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHP, Atlanta, GA 30333 USAZebrone Kacheche - UNC Project Malawi, Lilongwe, MalawiDumbani Kayira - UNC Project Malawi, Lilongwe, MalawiCharles Chasela - UNC Project Malawi, Lilongwe, MalawiCharles van der Horst - Univ N Carolina, Chapel Hill, NC USADenise J. Jamieson - Ctr Dis Control & Prevent, Div Reprod Hlth, NCCDPHP, Atlanta, GA 30333 USA
- Resource Type
- Journal article
- Publication Details
- The Journal of infectious diseases, Vol.208(4), pp.653-661
- DOI
- 10.1093/infdis/jit221
- PMID
- 23687226
- PMCID
- PMC3719904
- NLM abbreviation
- J Infect Dis
- ISSN
- 0022-1899
- eISSN
- 1537-6613
- Publisher
- Oxford Univ Press
- Number of pages
- 9
- Grant note
- U48DP000059 / NATIONAL CENTER FOR CHRONIC DISEASE PREV AND HEALTH PROMO; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA DHHS/NIH/FIC 2-D43 Tw01039-06; R24 Tw00798 / NIH Fogarty AIDS International Training and Research Program US Agency for International Development; United States Agency for International Development (USAID) P30A01050409 / Emory University Center For AIDS Research Immunology Core Elizabeth Glaser Pediatric AIDS Foundation D43TW001039 / FOGARTY INTERNATIONAL CENTER; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Fogarty International Center (FIC) SIP 13-01 U48-CCU409660-09; SIP 26-04 U48-DP000059-01; SIP 22-09 U48-DP001944-01 / Prevention Research Centers Special Interest Project of the Centers for Disease Control and Prevention Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA P30AI050410 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) NIH Fogarty AIDS International Training and Research Program (American Recovery and Reinvestment Act) P30-AI50410 / University of North Carolina Center for AIDS Research World Food Program National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) Malawi Ministry of Health and Population United Nations Children's Fund R24HD050924 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
- Language
- English
- Date published
- 08/15/2013
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446400202771
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