HIV-1 transmission through breast-milk: Appraisal of risk according to duration of feeding

Maurizio De Martino, Pier Angelo Tovo, Alberto Eugenio Tozzi, Patrizio Pezzotti, Luisa Galli, Susanna Livadiotti, Desirée Caselli, Emilia Massironi, Ezia Ruga, Francesca Fioredda, Anna Plebani, Clara Gabiano, Gian Vincenzo Zuccotti

Research output: Contribution to journalArticlepeer-review


Objectives: To estimate the risk of HIV-1 transmission through breast-milk in children born to infected mothers, and to determine the relationship between duration of breast-feeding and risk. Design and methods: The study population included 168 breast-fed and 793 bottle-fed children born to seropositive mothers. All subjects were enrolled and followed-up in the Italian Register for HIV Infection in Children; HIV serostatus was defined in all children. Multivariate analysis was performed using a logistic regression model. Independent variables included biological factors (duration of breast-feeding, gestational age, clinical condition of mother at delivery, mode of delivery, birth-weight and sex). Year of birth and age when HIV infection was diagnosed were also considered in the analysis attempting to control for possible selection biases. Results: Breast-feeding increased the risk of HIV-1 transmission. The estimated adjusted odds ratio for 1 day of breast- versus bottle-feeding was 1.19 (95% confidence interval, 1.10-1.28). The infection odds ratio of breast- versus bottle-feeding increased with the natural logarithm of the duration of practice. Conclusions: These results are the first to provide an appraisal of the additional risk of HIV-1 transmission associated with a seropositive mother breast-feeding her child. Biological significance of this route of transmission was supported by demonstration of a relationship between duration of breast-feeding and risk of HIV-1 transmission.

Original languageEnglish
Pages (from-to)991-997
Number of pages7
JournalAIDS (London, England)
Issue number9
Publication statusPublished - Sep 1992


  • Breast-feeding
  • Perinatal HIV-1 infection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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