Role of Breast Milk in Acquisition of Cytomegalovirus Infection

Abstract

The prevalence of IgG antibody against cytomegalovirus (CMV) was compared between the age-matched (0 month to 2 years of age) groups of 212 breast-fed children and 223 bottle-fed children to examine the role of breast milk for acquisition of CMV. Mothers of both groups of children were also examined for CMV IgG antibodies. Both the breast-fed and bottle-fed children groups showed high seropositivity for CMV at 0 to 2 months of age, which gradually decreased and bottomed at 6 to 8 months of age. Thereafter, in the breast-fed children group, the seropositivity rate increased up to 70% by 1 year of age. In contrast, in the bottle-fed children group, the seropositivity rate remained at the bottom level of lower than 30%, without showing any apparent increases. The serological data of the children whose mothers were confirmed to be seropositive, revealed that mother-to-child transmission of CMV occurred in 11 of 17 (64.7%) of the breast-fed children and in 24 of 87 (27.6%) of the bottle-fed children. All the bottle-fed children born to seronegative mothers remained seronegative for CMV up to 1 year of age. The bottle-fed children showed significantly lower seropositivity than the breast-fed children, although most of both groups of children were born to seropositive mothers. The results strongly suggested that about 40% of the breast-fed children acquire CMV via breast milk and breast-feeding has certain protective effects on congenital CMV disease in the offspring. CMV is known to be one of the most common viruses which are transmitted transplacentally. In fact, congenital CMV infection occurs at incidences ranging from 0.2 to 2.2% among all live births, as reviewed by Stagno and Whitley (15). Although most of these congenitally infected newborns show no clinical signs of CMV infection, approximately 10% of them will develop congenital cytomegalic inclusion disease with sequelae (1, 11).Moreover, CMV infection which occurs during or after delivery is much more common than congenital infection. Such perinatal CMV infection is usually acquired through contact with breast milk and/or cervical secretions. In fact, Numazaki et al reported that approximately 30% of the pregnant women excreted CMV in the cervical excretions and more than 60% of newborn infants in Japan were vertically infected by CMV via the birth canal (8). On the other hand, CMV was isolated from breast milk, and CMV infection via breast milk was also reported (2, 5, 9, 13). Breast milk has then also been considered as an important route of mother-to-child transmission of CMV (9). In the present study, we compared the prevalence of CMV antibodies between the age-matched groups of breast-fed children and bottle-fed children. The serological status of mothers of both the breast-fed and bottle-fed children was also examined. An evidence that the seropositivity is apparent higher in the breast-fed children than in the bottle-fed children suggests an important role of breast milk

Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection

“…On the other hand, the increased use of day care centres could increase CMV seroprevalence in developed countries. Several developed countries such as Japan [35][36][37], Sweden [38], and Taiwan [38,39] have high CMV seroprevalences, suggesting that there is not a straightforward relationship between socioeconomic conditions and CMV seroprevalence.…”

“…To reduce sampling variability, we only included countries that had at least 500 women tested. Studies were from Australia [44], Belgium [45][46][47], Brazil [48,49], Canada [25,[50][51][52], Chile [53,54], England [23,[55][56][57][58][59][60][61], Finland [62], France [63][64][65][66], Germany [67,68], Ghana [69], India [70][71][72], Israel [73,74], Italy [75][76][77], Japan [35,37,78,79], Scotland [80], South Africa [27], Spain [43], Sweden [38], Taiwan [39,81], Turkey [82][83][84] and the United States …”

Multiple independent lineages of HIV-1 persist in breast milk and plasma

“…One potential anatomical origin of the initial breast milk viral lineage is infected epithelial cells in the mammary gland [49], as in the case of mouse mammary tumor virus [50]; however, epithelial cells lack the CD4 receptor and probably do not comprise a significant portion of HIV-1 infected cells. A more likely origin of HIV-1 in breast milk is infected cells from gut-associated lymphoid tissue (GALT) [16, 51, 52].…”

Human Cytomegalovirus Latency and Reactivation – A Delicate Balance between the Virus and Its Host’s Immune System

“…Generally, primary HCMV infection takes place during childhood, and the virus is transmitted through close personal contact. All bodily excretions are possible sources of HCMV transmission and most children become infected via breast milk [3] or via transmission from child to child in day-care centers and schools [2,4]. HCMV can also be transferred by blood products, bone marrow grafts and solid-organ transplants, and several studies have identified leukocytes as the most important source of virus in blood products [5][6][7].…”