The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers

Details

• Alternative Title:
  Matern Child Nutr
• Personal Author:
  Hampel, Daniela ; Shahab-Ferdows, Setareh ; Gertz, Erik ; Flax, Valerie L. ; Adair, Linda S. ; Bentley, Margaret E. ; Jamieson, Denise J. ; Tegha, Gerald ; Chasela, Charles S. ; Kamwendo, Debbie ; van der Horst, Charles M. ; Allen, Lindsay H.
• Description:
  We evaluated effects of antiretroviral (ARV) therapy and lipid-based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV-infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post-partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant-pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post-partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80-90% of copper and zinc and <50% of iron concentrations met the current adequate intake for infants at 2 weeks and only 1-19% at 24 weeks. Pregnancy haemoglobin was negatively correlated with milk iron at 2 and 6 weeks (r = -.18, p < .02 for both). The associations of the milk minerals with each other were the strongest correlations observed (r = .11-.47, p < .05 for all); none were found with infant biomarkers. At 2 weeks, moderately anaemic women produced milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α-1-acid glycoprotein and C-reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation.
• Keywords:
  Adult Anti-HIV Agents Biomarkers Breast Feeding Copper Dietary Supplements Female Hemoglobins Hemoglobin Status HIV HIV Infections Human Milk Humans Infant Infant, Newborn Inflammation Iron Lipids Malawi Male Milk, Human Mothers Young Adult Zinc

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• Source:
  Matern Child Nutr. 14(2):e12503
• Pubmed ID:
  28851037
• Pubmed Central ID:
  PMC5832511
• Document Type:
  Journal Article
• Funding:
  U48 DP001944/DP/NCCDPHP CDC HHSUnited States/ ; D43 TW001039/TW/FIC NIH HHSUnited States/ ; U48DP001944/ACL/ACL HHSUnited States/ ; R24 TW007988/TW/FIC NIH HHSUnited States/ ; P30 DK056350/DK/NIDDK NIH HHSUnited States/ ; R24 HD050924/HD/NICHD NIH HHSUnited States/ ; P2C HD050924/HD/NICHD NIH HHSUnited States/ ; U48 DP000059/DP/NCCDPHP CDC HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/
• Volume:
  14
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:023ab03072bce0a84124ee79196844a83363c8293527bd3ea28511e23bc08f69
• Download URL:
  https://stacks.cdc.gov/view/cdc/52161/cdc_52161_DS1.pdf
• File Type:
  [PDF - 2.15 MB ]