The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers

Daniela Hampel; Setareh Shahab-Ferdows; Erik Gertz; Valerie L Flax; Linda S Adair; Margaret E Bentley; Denise J Jamieson; Gerald Tegha; Charles S Chasela; Debbie Kamwendo; Charles M van der Horst; Lindsay H Allen

doi:10.1111/mcn.12503

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The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers

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The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers

Daniela Hampel, Setareh Shahab-Ferdows, Erik Gertz, Valerie L Flax, Linda S Adair, Margaret E Bentley, Denise J Jamieson, Gerald Tegha, Charles S Chasela, Debbie Kamwendo, …

Maternal and child nutrition, Vol.14(2), pp.e12503-n/a

04/2018

DOI: 10.1111/mcn.12503

PMCID: PMC5832511

PMID: 28851037

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Abstract

We evaluated effects of antiretroviral (ARV) therapy and lipid-based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV-infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post-partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant-pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post-partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80-90% of copper and zinc and <50% of iron concentrations met the current adequate intake for infants at 2 weeks and only 1-19% at 24 weeks. Pregnancy haemoglobin was negatively correlated with milk iron at 2 and 6 weeks (r = -.18, p < .02 for both). The associations of the milk minerals with each other were the strongest correlations observed (r = .11-.47, p < .05 for all); none were found with infant biomarkers. At 2 weeks, moderately anaemic women produced milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α-1-acid glycoprotein and C-reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation.

Adult

Anti-HIV Agents - pharmacology

Anti-HIV Agents - therapeutic use

Biomarkers - blood

Breast Feeding

Copper - metabolism

Dietary Supplements

Female

Hemoglobins - metabolism

HIV Infections - drug therapy

Humans

Infant

Infant, Newborn

Inflammation - blood

Iron - blood

Iron - metabolism

Lipids - administration & dosage

Lipids - pharmacology

Malawi

Male

Milk, Human - drug effects

Milk, Human - metabolism

Mothers

Young Adult

Zinc - metabolism

Details

Title: Subtitle: The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers
Creators: Daniela Hampel - Western Human Nutrition Research Center
Setareh Shahab-Ferdows - Western Human Nutrition Research Center
Erik Gertz - Western Human Nutrition Research Center
Valerie L Flax - University of North Carolina at Chapel Hill
Linda S Adair - University of North Carolina at Chapel Hill
Margaret E Bentley - University of North Carolina at Chapel Hill
Denise J Jamieson - Centers for Disease Control and Prevention
Gerald Tegha - UNC Project, Lilongwe, Malawi
Charles S Chasela - University of the Witwatersrand
Debbie Kamwendo - UNC Project, Lilongwe, Malawi
Charles M van der Horst - University of North Carolina at Chapel Hill
Lindsay H Allen - Western Human Nutrition Research Center
Resource Type: Journal article
Publication Details: Maternal and child nutrition, Vol.14(2), pp.e12503-n/a
DOI: 10.1111/mcn.12503
PMID: 28851037
PMCID: PMC5832511
NLM abbreviation: Matern Child Nutr
ISSN: 1740-8695
eISSN: 1740-8709
Grant note: P2C HD050924 / NICHD NIH HHS P30 DK056350 / NIDDK NIH HHS D43 TW001039 / FIC NIH HHS R24 TW007988 / FIC NIH HHS P30 AI050410 / NIAID NIH HHS U48 DP001944 / NCCDPHP CDC HHS R24 HD050924 / NICHD NIH HHS U48 DP000059 / NCCDPHP CDC HHS
Language: English
Date published: 04/2018
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446427502771

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