Vitamin Increases HIV in Breast Milk

Vitamin A and beta-carotene supplements are unsafe for HIV-positive women who breastfeed because they may boost the excretion of HIV in breast milk, thereby increasing the chances of transmitting the infection to the child, a pair of new studies suggest.

Epidemiologist Eduardo Villamor of the University of Michigan School of Public Health says transmission of HIV through breastfeeding happens because breast milk carries viral particles that the baby ingests. Supplementing HIV-positive women with vitamin A and beta-carotene appears to increase the amount of the virus in milk.

This may be partly because the same nutrients raise the risk of developing subclinical mastitis, an inflammatory condition that causes blood plasma to leak into the mammary gland and viral particles to then leak into the milk, he says.

Villamor's findings appear in two separate articles in the American Journal of Clinical Nutrition and the Journal of Nutrition. The results are significant because they provide biological explanations for a previous report that supplementation with these nutrients increased chances of mother-to-child HIV transmission.

“So there are now strong arguments to consider the implications of supplementation to pregnant or lactating women who are HIV-positive,” said Villamor, an associate professor of epidemiology and environmental health sciences. “It does not look like it’s a safe intervention for them.”

Mother-to-child HIV transmission is a huge problem in developing countries where HIV is prevalent, Villamor said. In 2008 alone, there were 430,000 new infections and more than 95% of those resulted from mother-to-child transmission. Most were in sub-Saharan Africa.