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Differences in Breastmilk Composition of HIV-Infected and HIV-Uninfected Mothers of Premature Infants: Effects of Antiretroviral Therapy.

Differences in Breastmilk Composition of HIV-Infected and HIV-Uninfected Mothers of Premature Infants: Effects of Antiretroviral Therapy.
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Fouché C, van Niekerk E, du Plessis LM,


Fouché C, van Niekerk E, du Plessis LM, (click to view)

Fouché C, van Niekerk E, du Plessis LM,

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Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 2016 8 16()

Abstract
INTRODUCTION
A key strategy to prevent mother-to-child transmission of the human immunodeficiency virus (HIV) and to reduce infant morbidity and mortality includes providing the HIV-exposed premature infant with breastmilk accompanied by dual anti-retroviral therapy (ART). The effects of HIV and ART on premature breastmilk composition are largely unknown. The aim of the study was to assess and compare the breastmilk composition of HIV-infected mothers receiving ART and HIV-uninfected mothers who gave birth to premature infants.

MATERIALS AND METHODS
Lactating HIV-infected women receiving ART (n = 38) and HIV-uninfected women (n = 36) with premature infants provided two breastmilk samples on days 7 and 9, respectively, of lactation. Breastmilk samples were analyzed for total energy, protein, carbohydrates, fat, phosphate, iron, zinc, and copper content.

RESULTS
Breastmilk of HIV-infected women contained higher protein (1.95 versus 1.78 g/100 g; p = 0.04), fat (4.42 versus 3.49 g/100 g; p = 0.01), and copper (0.64 versus 0.56 mg/L; p = 0.02) levels; whereas carbohydrate (5.37 versus 6.67 g/100 g; p = 0.002) and zinc (5.26 versus 5.78 mg/L; p = 0.04) levels were lower compared with those of HIV-uninfected women. Zinc levels were significantly lower in HIV-infected women with early gestation periods, and the lowest levels were observed in women who received ART for ≤4 weeks (0.58 mg/L; p = 0.03). Total energy (78.22 versus 61.48 kCal/100 mL) and fat levels (5.39 versus 3.00 g/100 mL) were significantly higher in the late gestation period HIV-infected women. Copper levels (0.61 mg/L) were higher in the late gestation period women who received >4 weeks of ART exposure (p = 0.05).

CONCLUSION
Differences existed in the breastmilk composition of HIV-infected women on ART compared with HIV-uninfected women. ART exposure period may influence breastmilk composition.

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