Homespun technology provides HIV-free breast milk

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Homespun technology provides HIV-free breast milk

Malakata, 25 May 2007

Source: SciDev.Net. [LUSAKA] Researchers have devised a simple and

cost-effective method of preventing breast milk transmission of HIV

from mother-to-child by 'flash-heating' infected milk to inactivate

the free-floating HIV virus.

A study, published online in the Journal of Acquired Immune

Deficiency Syndromes (21 May), provides hope that breastfeeding in

developing nations could become safer.

National banks that collect, store and disperse human milk already

pasteurise it, but commonly use a method that relies on thermometers

and timers that can be hard to obtain in resource-poor communities.

The new method involves simply heating a glass jar of expressed milk

in a pan of water over a flame or single burner, so can easily be

applied by mothers at home.

The research began in 2004 and was driven by HIV-positive mothers

from Zimbabwe wanting to know how they could make their milk safe for

their babies, according to Kiersten Israel-Ballard, from the US-based

Berkeley School of Public Health, who coordinated the study.

Of the 700,000 children who become infected with HIV each year, the

study says an estimated 40 per cent contract the virus from prolonged

breastfeeding that continues for more than six months.

The World Health Organization (WHO) recommends heat-treating HIV-

infected breast milk, but so far there has been sparse research into

a simple method that could be used by HIV-positive mothers in

developing countries.

" We wanted to be sure that there was scientific evidence that flash-

heated milk was truly free of HIV and immunologically beneficial, "

Israel Ballard told SciDev.Net.

Infants in developing countries at risk of potentially fatal

illnesses such as diarrhoea can't afford to lose antibodies or the

optimal nutrition found in breast milk.

In the study, 84 HIV-positive women contributed breast milk to the

research. Tests on flash-heated breast milk showed that the process

kills bacteria and the HIV virus, while retaining most of the milk's

nutritional and antimicrobial properties.

Canisius Banda, a spokesperson from the Zambia Ministry of Health,

told SciDev.Net that the challenge would be to educate mothers on how

to heat the milk.

Current WHO recommendations state that HIV positive mothers should

avoid breastfeeding when safe feeding alternatives are available. But

in regions where mothers cannot afford the cost of infant formula or

where water is contaminated, the WHO recommends mothers should

exclusively breastfeed their babies up to six months of age.

Link to abstract in Journal of Acquired Immune Deficiency Syndromes

Reference: Journal of Acquired Immune Deficiency Syndromes doi:

10.1097/QAI.0b013e318074eeca (2007)

Flash-Heat Inactivation of HIV-1 in Human Milk: A Potential Method to

Reduce Postnatal Transmission in Developing Countries.

BRIEF REPORT

JAIDS Journal of Acquired Immune Deficiency Syndromes. POST

ACCEPTANCE, 17 May 2007

Israel-Ballard, Kiersten MPH *; Donovan, PHD +; Chantry,

Caroline MD ++; Coutsoudis, PHD ; Sheppard, Haynes PHD +;

Sibeko, Lindiwe MSC [//]; Abrams, Barbara DRPH *

Abstract:

Background: Up to 40% of all mother-to-child transmission of HIV

occurs by means of breast-feeding; yet, in developing countries,

infant formula may not be a safe option. The World Health

Organization recommends heat-treated breast milk as an infant-feeding

alternative. We investigated the ability of a simple method, flash-

heat, to inactivate HIV in breast milk from HIV-positive mothers.

Methods: Ninety-eight breast milk samples, collected from 84 HIV-

positive mothers in a periurban settlement in South Africa, were

aliquoted to unheated control and flash-heating. Reverse

transcriptase (RT) assays (lower detection limit of 400 HIV

copies/mL) were performed to differentiate active versus inactivated

cell-free HIV in unheated and flash-heated samples.

Results: We found detectable HIV in breast milk samples from 31% (26

of 84) of mothers. After adjusting for covariates, multivariate

logistic regression showed a statistically significant negative

association between detectable virus in breast milk and maternal

CD4+T-lymphocyte count (P = 0.045) and volume of breast milk

expressed (P = 0.01) and a positive association with use of

multivitamins (P = 0.03). All flash-heated samples showed

undetectable levels of cell-free HIV-1 as detected by the RT assay

(P< 0.00001).

Conclusions: Flash-heat can inactivate HIV in naturally infected

breast milk from HIV-positive women. Field studies are urgently

needed to determine the feasibility of in-home flash-heating breast

milk to improve infant health while reducing postnatal transmission

of HIV in developing countries.