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Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

CC and CXC Chemokines in Breastmilk are Associated with Mother-to- Child HIV-1 Transmission

Author(s): Carey Farquhar, Dorothy A. Mbori-Ngacha, Mary W. Redman, Rose K. Bosire, Barbara L. Lohman, Anne L. Piantadosi, Richard B. Goodman, John T. Ruzinski, Sandy R. Emery, Christopher H. Crudder, Julie M. Overbaugh and Grace C. John-Stewart

Volume 3, Issue 4, 2005

Page: [361 - 369] Pages: 9

DOI: 10.2174/157016205774370393

Price: $65

Abstract

Introduction: CC and CXC chemokines may play a role in mother-to-child HIV-1 transmission by blocking HIV-1 binding to chemokine receptors and impeding viral entry into cells. Methods: To define correlates of breastmilk chemokines and associations with infant HIV-1 acquisition, chemokines in breastmilk and infant HIV-1 infection risk were assessed in an observational, longitudinal cohort study. We measured MIP-1α, MIP-1β, RANTES, and SDF-1 in month 1 breastmilk specimens from HIV- 1-infected women in Nairobi and HIV-1 viral load was calculated in maternal plasma and breastmilk at delivery and 1 month postpartum. Infant infection status was determined at birth and months 1, 3, 6, 9, and 12. Results: Among 281 breastfeeding women, 60 (21%) of their infants acquired HIV-1 during follow-up, 39 (65%) of whom became infected intrapartum or after birth. MIP-1α, MIP-1β, RANTES, and SDF-1 were all positively correlated with breastmilk HIV-1 RNA (P < 0.0005). Women with clinical mastitis had 50% higher MIP-1α and MIP-1β levels (P < 0.001 and P=0.006, respectively) and women with subclinical mastitis (breastmilk Na+/K+ > 1) had ∼70% higher MIP-1α, MIP-1β and RANTES (P < 0.002 for all) compared to women without mastitis. Independent of breastmilk HIV-1, increased MIP-1? and SDF-1 were associated with reduced risk of infant HIV-1 (RR=0.4; 95% CI 0.2-0.9; P=0.03 and RR=0.5; 95% CI=0.3-0.9; P=0.02, respectively) and increased RANTES was associated with higher transmission risk (RR=2.3; 95% CI 1.1- 5.3; P=0.04). Conclusions: These observations suggest a complex interplay between virus levels, breastmilk chemokines, and mother-to-child HIV-1 transmission and may provide insight into developing novel strategies to reduce infection across mucosal surfaces.

Keywords: mip, rantes, sdf, chemokines, mother-to-child hiv transmission, breastmilk


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