Premasticating Food for Weaning African Infants: A Possible Vehicle for Transmission of HIV

Maritz, E. R.; Kidd, Martin; Cotton, Mark F.

doi:10.1542/peds.2010-3109

Cited by 15 publications

(15 citation statements)

References 37 publications

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“…Though not considered a common mode of transmission [53], [54], and despite reports of antiviral activity of salivary components [55], relatively higher HIV RNA in saliva of women may represent unique, sex-dependent transmission risk associated with saliva; the transmission risk associated with oral-sex is low and still controversial. Such findings may have implications for HIV transmission in special circumstances, such as high viral replication and mandates further investigation [46], [56], [57], [58].…”

Section: Discussionmentioning

confidence: 99%

HIV-1 RNA Levels and Antiretroviral Drug Resistance in Blood and Non-Blood Compartments from HIV-1–Infected Men and Women enrolled in AIDS Clinical Trials Group Study A5077

et al. 2014

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BackgroundDetectable HIV-1 in body compartments can lead to transmission and antiretroviral resistance. Although sex differences in viral shedding have been demonstrated, mechanisms and magnitude are unclear. We compared RNA levels in blood, genital-secretions and saliva; and drug resistance in plasma and genital-secretions of men and women starting/changing antiretroviral therapy (ART) in the AIDS Clinical Trials Group (ACTG) 5077 study.MethodsBlood, saliva and genital-secretions (compartment fluids) were collected from HIV-infected adults (≥13 years) at 14 United-States sites, who were initiating or changing ART with plasma viral load (VL) ≥2,000 copies/mL. VL testing was performed on all compartment fluids and HIV resistance genotyping on plasma and genital-secretions. Spearman rank correlations were used to evaluate concordance and Fisher’s and McNemar’s exact tests to compare VL between sexes and among compartments.ResultsSamples were available for 143 subjects; 36% treated (23 men, 29 women) and 64% ‘untreated’ (40 men, 51 women). RNA detection was significantly more frequent in plasma (100%) than genital-secretions (57%) and saliva (64%) (P<0.001). A higher proportion of men had genital shedding versus women (78% versus 41%), and RNA detection was more frequent in saliva versus genital-secretions in women when adjusted for censoring at the limit of assay detection. Inter-compartment fluid VL concordance was low in both sexes. In 22 (13 men, 9 women) paired plasma-genital-secretion genotypes from treated subjects, most had detectable resistance in both plasma (77%) and genital-secretions (68%). Resistance discordance was observed between compartments in 14% of subjects.ConclusionsHIV shedding and drug resistance detection prior to initiation/change of ART in ACTG 5077 subjects differed among tissues and between sexes, making the gold standard blood-plasma compartment assessment not fully representative of HIV at other tissue sites. Mechanisms of potential sex-dependent tissue compartmentalization should be further characterized to aid in optimizing treatment and prevention of HIV transmission.Trial RegistrationClinicalTrials.gov NCT00007488

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Section: Discussionmentioning

confidence: 99%

HIV-1 RNA Levels and Antiretroviral Drug Resistance in Blood and Non-Blood Compartments from HIV-1–Infected Men and Women enrolled in AIDS Clinical Trials Group Study A5077

et al. 2014

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“…Beginning as early as one month of age and continuing for two years or more, the practice has been reported in nearly a third of 119 traditional societies surveyed in ethnographic literature (Pelto, Zhang & Habicht, 2010), and is still practiced across diverse societies today (e.g., China (Pelto, Zhang & Habicht, 2010), South Africa (Maritz, Kidd & Cotton, 2011)). Premasticating mechanically processes, lubricates, and adds salivary amylase to foods, facilitating digestion and absorption (Humphrey & Williamson, 2001) As such, the practice may have been favored throughout much of human evolution to enhance nutritional availability of weaning foods (Pelto, Zhang & Habicht, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…(Hesselmar et al, 2013). Conversely, others have raised concerns that premastication may transfer HIV (Maritz, Kidd & Cotton, 2011; Gaur et al, 2009) and bacteria with cariogenic or pathogenic potential, including group A streptococcus (Steinkuller, Chan & Rinehouse, 1992) and Streptococcus mutans (Berkowitz, Turner & Green, 1981). …”

Section: Introductionmentioning

confidence: 99%

Salivary microbiomes of indigenous Tsimane mothers and infants are distinct despite frequent premastication

Han

Martin

Dichosa

et al. 2016

PeerJ

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BackgroundPremastication, the transfer of pre-chewed food, is a common infant and young child feeding practice among the Tsimane, forager-horticulturalists living in the Bolivian Amazon. Research conducted primarily with Western populations has shown that infants harbor distinct oral microbiota from their mothers. Premastication, which is less common in these populations, may influence the colonization and maturation of infant oral microbiota, including via transmission of oral pathogens. We collected premasticated food and saliva samples from Tsimane mothers and infants (9–24 months of age) to test for evidence of bacterial transmission in premasticated foods and overlap in maternal and infant salivary microbiota. We extracted bacterial DNA from two premasticated food samples and 12 matched salivary samples from maternal-infant pairs. DNA sequencing was performed with MiSeq (Illumina). We evaluated maternal and infant microbial composition in terms of relative abundance of specific taxa, alpha and beta diversity, and dissimilarity distances.ResultsThe bacteria in saliva and premasticated food were mapped to 19 phyla and 400 genera and were dominated by Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes. The oral microbial communities of Tsimane mothers and infants who frequently share premasticated food were well-separated in a non-metric multi-dimensional scaling ordination (NMDS) plot. Infant microbiotas clustered together, with weighted Unifrac distances significantly differing between mothers and infants. Infant saliva contained more Firmicutes (p < 0.01) and fewer Proteobacteria (p < 0.05) than did maternal saliva. Many genera previously associated with dental and periodontal infections, e.g. Neisseria, Gemella, Rothia, Actinomyces, Fusobacterium, and Leptotrichia, were more abundant in mothers than in infants.ConclusionsSalivary microbiota of Tsimane infants and young children up to two years of age do not appear closely related to those of their mothers, despite frequent premastication and preliminary evidence that maternal bacteria is transmitted to premasticated foods. Infant physiology and diet may constrain colonization by maternal bacteria, including several oral pathogens.

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“…[2][3][4][5][6] Martiz and colleagues 6 from South Africa reported that markers of disrupted oral mucosal integrity and presence of blood in the mouth were frequently seen in the person who prechews and the child who receives prechewed food.…”

mentioning

confidence: 99%

“…2,5,6,11 While the role and potential benefits of these practices have been previously summarized, 11 research supporting them is lacking. The burden is on healthcare providers to review individualized risk-benefit-based counseling in the context of the country and culture in which they work and account for feeding options for families under their care.…”

mentioning

confidence: 99%

Prechewing and Prewarming Food for HIV-Exposed Children: A Prospective Cohort Experience from Latin America

Gaur

Cohen

Read

et al. 2013

AIDS Patient Care and STDs

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Premasticating Food for Weaning African Infants: A Possible Vehicle for Transmission of HIV

Cited by 15 publications

References 37 publications

HIV-1 RNA Levels and Antiretroviral Drug Resistance in Blood and Non-Blood Compartments from HIV-1–Infected Men and Women enrolled in AIDS Clinical Trials Group Study A5077

HIV-1 RNA Levels and Antiretroviral Drug Resistance in Blood and Non-Blood Compartments from HIV-1–Infected Men and Women enrolled in AIDS Clinical Trials Group Study A5077

Salivary microbiomes of indigenous Tsimane mothers and infants are distinct despite frequent premastication

Prechewing and Prewarming Food for HIV-Exposed Children: A Prospective Cohort Experience from Latin America

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