Journal of Infectious Diseases. 187(5):736–740, MARCH 1, 2003

DOI: 10.1086/374272

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PMID: 12599046

Issn Print: 0022-1899

Publication Date: March 1, 2003


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Breast-Milk Infectivity in Human Immunodeficiency Virus Type 1-Infected Mothers

Barbra Richardson;Grace John-Stewart;James Hughes;Ruth Nduati;Dorothy Mbori-Ngacha;Julie Overbaugh;Joan Kreiss;

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Abstract

Human immunodeficiency virus type 1 (HIV-1) is transmitted through blood, genital secretions, and breast milk. The probability of heterosexual transmission of HIV-1 per sex act is .0003-.0015, but little is known regarding the risk of transmission per breast-milk exposure. We evaluated the probability of breast-milk transmission of HIV-1 per liter of breast milk ingested and per day of breast-feeding in a study of children born to HIV-1-infected mothers. The probability of breast-milk transmission of HIV-1 was .00064 per liter ingested and .00028 per day of breast-feeding. Breast-milk infectivity was significantly higher for mothers with more-advanced disease, as measured by prenatal HIV-1 RNA plasma levels and CD4 cell counts. The probability of HIV-1 infection per liter of breast milk ingested by an infant is similar in magnitude to the probability of heterosexual transmission of HIV-1 per unprotected sex act in adults

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