Increased Epstein–Barr virus in breast milk occurs with subclinical mastitis and HIV shedding

Sanosyan, Armen; Rutagwera, David; Molès, Jean‐Pierre; Bolloré, Karine; Peries, Marianne; Kankasa, Chipepo; Mwiya, Mwiya; Tylleskär, Thorkild; Nagot, Nicolas; Perre, Philippe Van de; Tuaillon, Édouard

doi:10.1097/md.0000000000004005

Cited by 12 publications

(17 citation statements)

References 47 publications

(63 reference statements)

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“…The lack of significance could be explained by a generally low exposure to EBV in this age group and hence an underpowered comparison. In the same age group of 0.5-2 years old, there was a noticeable difference for CMV IgG seropositivity, which could be explained by higher contagiousness of CMV in early childhood and unnoticed transmission by breastfeeding, which may transmit CMV but far less commonly EBV (76)(77)(78)(79)(80)(81)(82). The differences in seroprevalance between EBV and CMV seem to decrease as age increases in our KD cohort.…”

Section: Discussionmentioning

confidence: 55%

Lower CMV and EBV Exposure in Children With Kawasaki Disease Suggests an Under-Challenged Immune System

et al. 2021

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Background: Kawasaki Disease (KD) is a pediatric vasculitis of which the pathogenesis is unclear. The hypothesis is that genetically pre-disposed children develop KD when they encounter a pathogen which remains most often unidentified or pathogen derived factors. Since age is a dominant factor, prior immune status in children could influence their reactivity and hence the acquisition of KD. We hypothesized that systemic immune responses early in life could protect against developing KD. With this study we tested whether the incidence of previous systemic cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection is lower in children with KD compared to healthy age-matched controls.Methods and Results: We compared 86 KD patients with an age-matched control group regarding CMV and EBV VCA IgG measurements (taken before or 9 months after IVIG treatment). We found that both CMV and EBV had an almost 2-fold lower seroprevalence in the KD population than in the control group.Conclusions: We suggest that an under-challenged immune system causes an altered immune reactivity which may affect the response to a pathological trigger causing KD in susceptible children.

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Section: Discussionmentioning

confidence: 55%

Lower CMV and EBV Exposure in Children With Kawasaki Disease Suggests an Under-Challenged Immune System

et al. 2021

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“…Cytomegalovirus and Epstein–Barr virus that are part of the normal environment of the mammary gland can also facilitate breast milk HIV shedding and were found associated with HIV-1 transmission by breastfeeding in the same cohort [ 33 ]. Furthermore, in a recent study we reported that impaired capacity to secret IL-8 in breast milk during SCM was associated with detection of Epstein–Barr virus in breast milk from HIV-infected Zambian women which may in turn fuel HIV shedding [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Whereas clinical mastitis occurs in less than 10% of lactating mothers [ 22 – 24 ], SCM (Na/K > 1) is more frequent, especially at start of breastfeeding in the first few days after delivery and again at the time of weaning, with a prevalence ranging from 9 to 45% in mature milk in HIV-uninfected mothers [ 17 , 18 ]. Studies have suggested that SCM may be associated with HIV shedding in breast milk and HIV mother-to-child transmission [ 25 – 34 ].…”

Section: Introductionmentioning

confidence: 99%

The immune response to sub-clinical mastitis is impaired in HIV-infected women

et al. 2018

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BackgroundSubclinical mastitis (SCM) is relatively common in lactating women and may be associated with HIV shedding in breast milk. The potential association between HIV infection and breast milk immunologic factors and immune response to SCM needs to be addressed.MethodsIn this cross-sectional study, SCM (Na/K ratio > 1) was tested in 165 mature breast milk samples collected from 40 HIV-infected women who didn’t transmit HIV to their child by breastfeeding and 43 HIV-uninfected women enrolled in an interventional cohort in South-Africa (Vertical Transmission Study). The level of 33 immune markers related to Th1/Th2 related response, inflammation and bacterial exposure were compared in ART-naive HIV-infected versus HIV-uninfected women. The associations between HIV infection and SCM on the concentration of immune factors were tested separately by Wilcoxon rank-sum test and corrected for false discovery rate. To control for potential confounder effects and take into account the clustering of breast milk samples from a single woman, multivariate mixed linear models adjusted on child age at the time of sampling were performed for each immune factor.ResultsSubclinical mastitis was detected in 15 (37.5%) HIV-infected women and 10 (23.3%) HIV-uninfected women. In the absence of SCM, the breast milk levels of IP-10 and MIG were higher and IL1-RA lower in HIV-infected women than in HIV-uninfected women (respectively p < 0.001, p = 0.001, p = 0.045). In HIV-uninfected women, SCM was characterized by a robust immune response with higher concentrations of a broad panel of Th1 and inflammatory related immune markers than in samples without SCM. By contrast, in HIV-infected women a limited number of immune markers were increased and lower increases were observed in samples with SCM than without SCM.ConclusionHIV infection in ART-naïve women was associated with elevated breast milk levels of IP-10 and MIG, which areTh1-related cytokines induced by IFN-γ. During SCM, a lower and narrower immune response was observed in HIV-infected than HIV-uninfected women, suggesting that HIV infection affects the capacity of the mammary gland to respond to SCM.Electronic supplementary materialThe online version of this article (10.1186/s12967-018-1667-4) contains supplementary material, which is available to authorized users.

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“…Milk composition may even vary between breasts—especially regarding immune factors; this fact has been particularly important in the study of HIV transmission through breastfeeding. 14 For other milk components, such as microbiota, there exists very little research characterizing modifiable factors (e.g., time of day and time within feed) related to variation; in these situations, best practices and standardization (although not optimization) are typically employed to ensure that samples are collected in a way that reduces risk of contamination and allows data to be compared across studies.…”

Section: Introductionmentioning

confidence: 99%