HIV Transmission

It is well established that infants breast fed by their HIV-infected mothers are at risk of acquiring HIV infection through breast milk. However, in low resource settings, where the HIV epidemic now predominates, breast feeding cannot simply be replaced by breast milk substitutes since alternatives to breast milk are unavailable, unaffordable and unsafe. The Zambia Exclusive Breastfeeding Study (ZEBS) aim to test the safety and efficacy of short duration exclusive breast feeding to minimize risks of HIV transmission without increasing risks of non-HIV infant mortality.

The Bode Lab has analyzed the composition of human milk oligosaccharides (HMOs) in the ZEBS breast milk samples and, together we discovered that

• HIV-infected women with higher total HMO concentrations are less likely to transmit HIV via breastfeeding,
• HIV-infected women with higher relative anbundance of the specific HMO 3'-sialyllactose (3'SL) are more likely to transmit HIV via breastfeeding, 
• higher concentrations of specific HMOs are associated with reduced mortality in HIV-exposed, uninfected (HEU) infants during, but not after breastfeeding
• the protective effects of HMOs on infant mortality discovered in HEU infants were not observed in HIV-infected infants
• maternal HIV infection influences the microbiome of HEU infants
• HMO composition differs between HIV-infected and HIV-uninfected women

48. Bender JM, Li F, Martelly S, Byrt E, Rouzier V, Leo M, Tobin N, Pannaraj PS, Adisetiyo H, Rollie A, Santiskulvong C, Wang S, Autran C, Bode L, Fitzgerald D, Kuhn L, Aldrovandi GM (2016) Maternal HIV Infection Influences the Microbiome of HIV-Uninfected Infants. Science Translational Medicine 8(349):349ra100  [Research Article, PubMed]

43. Wahl A, Baker C, Spagnuolo RA, Stamper L, Fouda G, Permar S, Hinde K, Kuhn L, Bode L, Aldrovandi G, Garcia JV (2015) Breast milk of HIV-positive mothers has potent and species-specific in vivo HIV inhibitory activity. J Virol 89(21):10868-78 [Research Article, PubMed]

40.  Kuhn L, Kim HY, Hsiao L, Nissan C, Kankasa C, Mwiya M, Thea DM, Aldrovandi GM, Bode L (2015) Oligosaccharide composition of breast milk influences survival of uninfected children born to HIV-infected mothers in Lusaka, Zambia. J Nutr. 145(1):66-72  [Research Article, PubMed]

32.  Chan CS, Kim HT, Autran C, Kim JH, Sinkala M, Kankasa C, Mwiya N, Thea DM, Aldrovandi GM, Kuhn L, Bode L (2013) Human milk Galectin-3 Binding Protein (Gal3BP)  and breastfeeding-associated  HIV transmission. Pediatr Infect Dis J.32(12):e473-5   [Research Article, PubMed]

26.  Bode L, Kuhn L, Kim HY, Hsiao L, Nissan C, Sinkala M, Kankasa C, Mwiya M, Thea DM, Aldrovandi GM (2012) Human Milk Oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding. Am J Clin Nutr. 96:831-9   [Research Article, PubMed]