Association between breast milk fatty acids and HIV-1 transmission through breastfeeding

Abstract

A residual mother-to-child transmission of HIV through breastfeeding persists despite prophylaxis. We identified breast milk fatty acids (FA) associated with postnatal HIV transmission through breastfeeding in a case-control study. Cases (n=23) were HIV-infected women with an infant who acquired HIV after 6 weeks of age. Controls (n=23) were matched on infant׳s age at sample collection. Adjusting for maternal antenatal plasma CD4 T cell count, cis-vaccenic acid (18:1n-7) and eicosatrienoic acid (20:3n-3) were associated with HIV transmission in opposite dose-response manner: OR (tertile 3 versus tertile 1): 10.8 and 0.16, p for trend=0.02 and 0.03, respectively. These fatty acids correlated with HIV RNA load, T helper-1 related cytokines, IL15, IP10, and β2 microglobulin, positively for cis-vaccenic acid, negatively for eicosatrienoic acid. These results suggested a change in FA synthesis by mammary gland cells leading to increased cis-vaccenic acid in milk of mothers who transmitted HIV to their infant during breastfeeding.

Changes in Fatty Acid Composition of Human Milk in Response to Cold-Like Symptoms in the Lactating Mother and Infant

“…All three n6 PUFAs; linoleic, DGLA and AA, were shown to have similar protective potency in vitro [ 10 ]. However, this protective effect of n6 PUFAs was not found by Badiou et al [ 24 ]. We did not find a statistically significant relationship between the mean proportion of the essential n6 PUFA linoleic acid and the health of the mother, infant, or both.…”

Subclinical mastitis occurs frequently in association with dramatic changes in inflammatory/anti-inflammatory breast milk components

“…In addition, inflammation in breast milk interplays with breast milk fatty acid profile. Hence, we recently observed that IL15, IP10, and β2 microglobulin, correlate positively for cis-vaccenic acid, and negatively for eicosatrienoic acid in breast milk collected from HIV infected mothers [26].…”

“…IL-8 is a chemokine produced by macrophages and epithelial cells, both of which are an important fraction of the breast milk cellular composition [11]. IL-8 is a major mediator of the inflammatory response 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 collected from HIV infected mothers [26].…”

Biological Role of Unsaturated Fatty Acid Desaturases in Health and Disease

“…When D6D is less active than elongase 5 the amount of ETE in breast milk increases. A higher concentration of ETE was associated with a lower risk of HIV-1 transmission [213]. Unfortunately, a large prospective cohort study is still lacking in this matter.…”