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Wednesday, April 17, 2024

Reducing active HIV in breast milk feasible, according to new study

A simple but effective method of flash-heating breast milk can inactivate the human immunodeficiency virus (HIV), according to a new study led by UC Davis researchers.
The study looks at the feasibility of reducing the transmission of the AIDS-causing virus from HIV-infected mothers to their infants in sub-Saharan Africa, a limited-resource area. Though the World Health Organization (WHO) recommends that these mothers flash-heat their breast milk, they do not outline any specific processes for a mother in a developing country to do so; this study is the first to examine feasible methods for mothers in low-resource areas.
“Flash-heat is a simple process for a mother to do in her home when she doesn’t have any equipment or a thermometer,” said Kiersten Israel-Ballard, a former doctoral student at UC Berkeley’s School of Public Health and part of the study’s research team.
Flash-heating, a type of pasteurization method, can be done using very little resources. It involves a mother manually expressing her milk into a glass jar, which is then placed into a pan filled with water. The mother, using whatever means available to her, then heats the water in the pan to a boil. Once it boils, she removes the jar to cool.
“What that has done is brought the milk usually to around 70 degrees, which is enough to inactivate HIV,” Israel-Ballard said.
The study showed that women in resource-poor and urban Dar es Salaam, Tanzania could follow this treatment protocol an average of 10 weeks. According to the statistician on the study, Janet Peerson of the UC Davis Program in International and Community Nutrition, 100 women made up the sample size, with an estimated one-third willing to participate in flash-heating.
“[In the study] 51.4 percent of HIV-infected mothers whose infants tested HIV negative at five months were willing to express and flash-heat their breast milk,” Peerson said. “This was a greater proportion than the 33 percent that was anticipated.”
The researchers hope that flash-heating breast milk could be a more feasible method of reducing HIV transmission in resource-limited areas. However, in addition to flash-heating breast milk, the WHO also encourages HIV-positive women or their infants to take antiretroviral medication (ARV) while breast feeding.
“They [the WHO] recommend that the flash-heating be used if the antiretroviral is temporarily unavailable or if the transmission risk is increased because the baby has thrush or something like that,” said Caroline Chantry, professor of pediatrics at UC Davis Children’s Hospital and lead author of the study.
Unfortunately, recent surveys show that only about half of the women in resource-poor areas have access to ARV.
“Most women don’t have access to the extended treatment during breast feeding so that is why we think this [flash-heating] is particularly important,” Chantry said.
In addition to inactivating HIV, flash-heating is also effective in helping infants thrive from a developmental standpoint, as keeping babies breast-fed rather than on formula can give them access to more nutrition and antibodies.
“Because you’re not boiling the milk directly and because we’re doing this fast, it retains the majority of the antibodies that’s so good in the milk,” said Israel-Ballard. “You want to kill all the bad stuff but it’s so important to keep all the good.”
Chantry said that more research is needed to know how flash-heating breast milk could impact HIV transmission overall in sub-Saharan Africa and other resource-poor areas.

RACHEL KUBICA can be reached at science@theaggie.org.


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