dc.contributor.author | Rutagwera, David Gatsinzi | |
dc.contributor.author | Molès, Jean-Pierre | |
dc.contributor.author | Kankasa, Chipepo | |
dc.contributor.author | Mwiya, Mwiya | |
dc.contributor.author | Tuaillon, Edouard | |
dc.contributor.author | Peries, Marianne | |
dc.contributor.author | Nagot, Nicolas | |
dc.contributor.author | Van de Perre, Philippe | |
dc.contributor.author | Tylleskär, Thorkild | |
dc.date.accessioned | 2022-12-28T10:08:12Z | |
dc.date.available | 2022-12-28T10:08:12Z | |
dc.date.created | 2022-04-10T15:28:52Z | |
dc.date.issued | 2022 | |
dc.identifier.issn | 1664-3224 | |
dc.identifier.uri | https://hdl.handle.net/11250/3039617 | |
dc.description.abstract | Subclinical mastitis (SCM) is an important risk factor of postnatal HIV-1 transmission that is still poorly understood. A longitudinal sub-study of the ANRS12174 trial including 270 breastfeeding mothers in Lusaka, Zambia measured sodium (Na+) and potassium (K+) in archived paired breast milk samples collected at week 14, 26 and 38 postpartum to determine cumulative incidence of SCM and the effects of recurrent severe SCM on HIV-1 shedding in breast milk. A nested retrospective cohort study including 112 mothers was also done to determine longitudinal effects of SCM on four pro-inflammatory cytokines; IL6, IL8, IP10 and RANTES. The cumulative incidence for any SCM (Na+/K+ ratio > 0.6) and severe SCM (Na+/K+ ratio > 1) were 58.6% (95%CI: 52.7 – 64.5) and 27.8% (95%CI: 22.5 – 33.1), respectively. In majority of affected mothers (51.4%) severe SCM was recurrent. Both breasts were involved in 11.1%, 33.3% and 70% of the mothers with a single episode, 2 and 3 episodes respectively. In affected breasts, an episode of severe SCM resulted in steep upregulation of the four cytokines considered (IL8, IP10, RANTES and IL6) compared to: before and after the episode; contralateral unaffected breasts; and SCM negative control mothers. Recurrent severe SCM significantly increased the odds of shedding cell-free HIV-1 in breast milk (OR: 5.2; 95%CI: 1.7 – 15.6) whereas single episode of severe SCM did not (OR: 1.8; 95%CI: 0.8 – 4.2). A Na+/K+ ratio > 1 indicative of severe SCM is an excellent indicator of breast inflammation characterized by a steep, localized and temporal upregulation of several pro-inflammatory cytokines that favor HIV-1 shedding in mature breast milk and may facilitate postnatal HIV-1 transmission through breastfeeding. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Frontiers | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Recurrent Severe Subclinical Mastitis and the Risk of HIV Transmission Through Breastfeeding | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2022 The Author(s) | en_US |
dc.source.articlenumber | 822076 | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.3389/fimmu.2022.822076 | |
dc.identifier.cristin | 2016506 | |
dc.source.journal | Frontiers in Immunology | en_US |
dc.identifier.citation | Frontiers in Immunology. 2022, 13, 822076. | en_US |
dc.source.volume | 13 | en_US |