Cargando…
Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa
BACKGROUND: Breastfeeding imparts beneficial immune protection and nutrition to infants for healthy growth, but it is also a route for human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV) infection. In previous studies, we showed that HCMV adversely affects infant development in Afric...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407128/ https://www.ncbi.nlm.nih.gov/pubmed/27103488 http://dx.doi.org/10.1093/jpids/piw015 |
_version_ | 1783232094554554368 |
---|---|
author | Musonda, Kunda G. Nyonda, Mary Filteau, Suzanne Kasonka, Lackson Monze, Mwaka Gompels, Ursula A. |
author_facet | Musonda, Kunda G. Nyonda, Mary Filteau, Suzanne Kasonka, Lackson Monze, Mwaka Gompels, Ursula A. |
author_sort | Musonda, Kunda G. |
collection | PubMed |
description | BACKGROUND: Breastfeeding imparts beneficial immune protection and nutrition to infants for healthy growth, but it is also a route for human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV) infection. In previous studies, we showed that HCMV adversely affects infant development in Africa, particularly with maternal HIV exposure. In this study, we analyzed infants risks for acquisition of HCMV infection from breastfeeding and compared HIV-positive and HIV-negative mothers. METHODS: Two cohorts were studied in Zambia. (1) Two hundred sixty-one HIV-infected and HIV-uninfected mothers were compared for HCMV deoxyribonucleic acid (DNA) loads and genotypes (glycoprotein gO) in milk from birth to 4 months postpartum. (2) Maternally HIV-exposed and HIV-unexposed infants were compared for HCMV infection risk factors. The second cohort of 460 infants, from a trial of micronutrient-fortified complementary-food to breastfeeding, were studied between 6 and 18 months of age. Human cytomegalovirus seroprevalence was assayed, and logistic regression was used to calculate risk factors for HCMV infection, including maternal HIV exposure and breastfeeding duration. RESULTS: Human cytomegalovirus was detected in breast milk from 3 days to 4 months postpartum, with significantly raised levels in HIV-positive women and independent of genotype. In infants, HCMV antibody seroprevalence was 83% by 18 months age. Longer breastfeeding duration increased infection risk in maternally HIV-unexposed (odds ratio [OR] = 2.69 for 18 months vs <12 months; 95% confidence interval [CI], 0.84–8.59; P = .03) and HIV-exposed infants (OR = 20.37 for >6 months vs never; 95% CI, 3.71–111.70; P < .001). CONCLUSIONS: Prolonged breastfeeding, which is common in Africa, increased risk of HCMV infection in infants. Both HIV-positive and HIV-negative women had extended milk HCMV secretion. Women who were HIV-positive secreted higher HCMV levels, and for longer duration, with their children at increased infection risk. Human cytomegalovirus control is required to maintain health benefits of breastfeeding. |
format | Online Article Text |
id | pubmed-5407128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-54071282017-05-03 Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa Musonda, Kunda G. Nyonda, Mary Filteau, Suzanne Kasonka, Lackson Monze, Mwaka Gompels, Ursula A. J Pediatric Infect Dis Soc Original Articles and Commentaries BACKGROUND: Breastfeeding imparts beneficial immune protection and nutrition to infants for healthy growth, but it is also a route for human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV) infection. In previous studies, we showed that HCMV adversely affects infant development in Africa, particularly with maternal HIV exposure. In this study, we analyzed infants risks for acquisition of HCMV infection from breastfeeding and compared HIV-positive and HIV-negative mothers. METHODS: Two cohorts were studied in Zambia. (1) Two hundred sixty-one HIV-infected and HIV-uninfected mothers were compared for HCMV deoxyribonucleic acid (DNA) loads and genotypes (glycoprotein gO) in milk from birth to 4 months postpartum. (2) Maternally HIV-exposed and HIV-unexposed infants were compared for HCMV infection risk factors. The second cohort of 460 infants, from a trial of micronutrient-fortified complementary-food to breastfeeding, were studied between 6 and 18 months of age. Human cytomegalovirus seroprevalence was assayed, and logistic regression was used to calculate risk factors for HCMV infection, including maternal HIV exposure and breastfeeding duration. RESULTS: Human cytomegalovirus was detected in breast milk from 3 days to 4 months postpartum, with significantly raised levels in HIV-positive women and independent of genotype. In infants, HCMV antibody seroprevalence was 83% by 18 months age. Longer breastfeeding duration increased infection risk in maternally HIV-unexposed (odds ratio [OR] = 2.69 for 18 months vs <12 months; 95% confidence interval [CI], 0.84–8.59; P = .03) and HIV-exposed infants (OR = 20.37 for >6 months vs never; 95% CI, 3.71–111.70; P < .001). CONCLUSIONS: Prolonged breastfeeding, which is common in Africa, increased risk of HCMV infection in infants. Both HIV-positive and HIV-negative women had extended milk HCMV secretion. Women who were HIV-positive secreted higher HCMV levels, and for longer duration, with their children at increased infection risk. Human cytomegalovirus control is required to maintain health benefits of breastfeeding. Oxford University Press 2016-06 2016-04-21 /pmc/articles/PMC5407128/ /pubmed/27103488 http://dx.doi.org/10.1093/jpids/piw015 Text en © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles and Commentaries Musonda, Kunda G. Nyonda, Mary Filteau, Suzanne Kasonka, Lackson Monze, Mwaka Gompels, Ursula A. Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title | Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title_full | Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title_fullStr | Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title_full_unstemmed | Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title_short | Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa |
title_sort | increased cytomegalovirus secretion and risks of infant infection by breastfeeding duration from maternal human immunodeficiency virus positive compared to negative mothers in sub-saharan africa |
topic | Original Articles and Commentaries |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407128/ https://www.ncbi.nlm.nih.gov/pubmed/27103488 http://dx.doi.org/10.1093/jpids/piw015 |
work_keys_str_mv | AT musondakundag increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica AT nyondamary increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica AT filteausuzanne increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica AT kasonkalackson increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica AT monzemwaka increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica AT gompelsursulaa increasedcytomegalovirussecretionandrisksofinfantinfectionbybreastfeedingdurationfrommaternalhumanimmunodeficiencyviruspositivecomparedtonegativemothersinsubsaharanafrica |