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Lee YS, Bang SM, Lee YS. Benefits and Risks of Antiviral Treatment during Pregnancy in Patients with Chronic Hepatitis B. J Clin Med 2021; 10:2320. [PMID: 34073357 PMCID: PMC8198811 DOI: 10.3390/jcm10112320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
Hepatitis B virus (HBV) is a main cause of chronic liver disease worldwide and can lead to severe liver diseases. The World Health Organization has planned to eliminate viral hepatitis, including hepatitis caused by HBV and hepatitis C virus, by 2030. As mother-to-child transmission (MTCT) of HBV is a main cause of chronic HBV infection, MTCT prevention is the main target to reduce the risk of chronic HBV infection and eliminate the disease. Recent clinical trials and meta-analyses found that antiviral therapy could prevent MTCT effectively in mothers with ≥200,000 IU/mL of HBV DNA, in combination with serial vaccination and hepatitis B immune globulin administration in infants. Despite the preventive role of antivirals for MTCT of HBV, there are several concerns regarding antiviral therapy with respect to the safety of the mother and fetus during pregnancy. This review summarizes the benefits and risks of antiviral treatment during pregnancy in women with chronic HBV infection.
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Affiliation(s)
| | | | - Young-Sun Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea; (Y.S.L.); (S.M.B.)
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Pitino MA, O'Connor DL, McGeer AJ, Unger S. The impact of thermal pasteurization on viral load and detectable live viruses in human milk and other matrices: a rapid review. Appl Physiol Nutr Metab 2020; 46:10-26. [PMID: 32650645 DOI: 10.1139/apnm-2020-0388] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Holder pasteurization (62.5 °C, 30 min) of human milk is thought to reduce the risk of transmitting viruses to an infant. Some viruses may be secreted into milk - others may be contaminants. The effect of thermal pasteurization on viruses in human milk has yet to be rigorously reviewed. The objective of this study is to characterize the effect of common pasteurization techniques on viruses in human milk and non-human milk matrices. Databases (MEDLINE, Embase, Web of Science) were searched from inception to April 20th, 2020, for primary research articles assessing the impact of pasteurization on viral load or detection of live virus. Reviews were excluded, as were studies lacking quantitative measurements or those assessing pasteurization as a component of a larger process. Overall, of 65 131 reports identified, 109 studies were included. Pasteurization of human milk at a minimum temperature of 56-60 °C is effective at reducing detectable live virus. In cell culture media or plasma, coronaviruses (e.g., SARS-CoV, SARS-CoV-2, MERS-CoV) are highly susceptible to heating at ≥56 °C. Although pasteurization parameters and matrices reported vary, all viruses studied, except parvoviruses, were susceptible to thermal killing. Future research important for the study of novel viruses should standardize pasteurization protocols and should test inactivation in human milk. Novelty In all matrices, including human milk, pasteurization at 62.5 °C was generally sufficient to reduce surviving viral load by several logs or to below the limit of detection. Holder pasteurization (62.5 °C, 30 min) of human milk should be sufficient to inactivate nonheat resistant viruses, including coronaviruses, if present.
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Affiliation(s)
- Michael A Pitino
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Allison J McGeer
- Department of Microbiology, Sinai Health, Toronto, ON M5G 1X5, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.,Department of Pediatrics, Sinai Health, Toronto, ON M5G 1X5, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
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Akinboyo IC, Crane GM, Chen L, Arav-Boger R. A 17-Year-Old Boy With Right Face Palsy, Left Leg Weakness, and Lytic Skull-Bone Lesions. J Pediatric Infect Dis Soc 2018; 7:350-354. [PMID: 29373673 PMCID: PMC6276027 DOI: 10.1093/jpids/pix101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/18/2017] [Indexed: 11/13/2022]
Abstract
Human T-cell lymphotropic virus (HTLV), an infection that is endemic in certain parts of Asia, Africa, and South America, has been associated with malignancy and neurological deficits. Here, we describe a pediatric patient with chronic HTLV-I infection who developed complications associated with HTLV-I (ie, adult T-cell leukemia/lymphoma and HTLV-I-associated myelopathy/tropical spastic paraparesis). To our knowledge, this presentation in a child has never been described. The patient underwent a bone marrow transplant and, at the time of this writing, was in remission. This case report highlights the fact that HTLV-related complications, previously expected to occur after decades of infection, also can occur in pediatric patients, particularly those who acquired HTLV-I perinatally.
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Affiliation(s)
- Ibukunoluwa C Akinboyo
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland,Correspondence: I. C. Akinboyo, 200 N Wolfe St., Room 3155, Baltimore, MD 21287 ()
| | - Genevieve M Crane
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lingling Chen
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ravit Arav-Boger
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Pannaraj PS, Ly M, Cerini C, Saavedra M, Aldrovandi GM, Saboory AA, Johnson KM, Pride DT. Shared and Distinct Features of Human Milk and Infant Stool Viromes. Front Microbiol 2018; 9:1162. [PMID: 29910789 PMCID: PMC5992295 DOI: 10.3389/fmicb.2018.01162] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/14/2018] [Indexed: 01/01/2023] Open
Abstract
Infants acquire many of their microbes from their mothers during the birth process. The acquisition of these microbes is believed to be critical in the development of the infant immune system. Bacteria also are transmitted to the infant through breastfeeding, and help to form the microbiome of the infant gastrointestinal (GI) tract; it is unknown whether viruses in human milk serve to establish an infant GI virome. We examined the virome contents of milk and infant stool in a cohort of mother-infant pairs to discern whether milk viruses colonize the infant GI tract. We observed greater viral alpha diversity in milk than in infant stool, similar to the trend we found for bacterial communities from both sites. When comparing beta diversity, viral communities were mostly distinguishable between milk and infant stool, but each was quite distinct from adult stool, urine, and salivary viromes. There were significant differences in viral families in the infant stool (abundant bacteriophages from the family Siphoviridae) compared to milk (abundant bacteriophages from the family Myoviridae), which may reflect significant differences in the bacterial families identified from both sites. Despite the differences in viral taxonomy, we identified a significant number of shared viruses in the milk and stool from all mother-infant pairs. Because of the significant proportion of bacteriophages transmitted in these mother-infant pairs, we believe the transmission of milk phages to the infant GI tract may help to shape the infant GI microbiome.
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Affiliation(s)
- Pia S Pannaraj
- Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, United States.,Department of Pediatrics, Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Melissa Ly
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - Chiara Cerini
- Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Monica Saavedra
- Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Grace M Aldrovandi
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Abdul A Saboory
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - Kevin M Johnson
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - David T Pride
- Department of Pathology, University of California, San Diego, San Diego, CA, United States.,Department of Medicine, University of California, San Diego, San Diego, CA, United States
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Freudenheim JL, Genco RJ, LaMonte MJ, Millen AE, Hovey KM, Mai X, Nwizu N, Andrews CA, Wactawski-Wende J. Periodontal Disease and Breast Cancer: Prospective Cohort Study of Postmenopausal Women. Cancer Epidemiol Biomarkers Prev 2016; 25:43-50. [PMID: 26689418 PMCID: PMC4713270 DOI: 10.1158/1055-9965.epi-15-0750] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/29/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Periodontal disease has been consistently associated with chronic disease; there are no large studies of breast cancer, although oral-associated microbes are present in breast tumors. METHODS In the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, 73,737 women without previous breast cancer were followed. Incident, primary, invasive breast tumors were verified by physician adjudication. Periodontal disease was by self-report. HRs and 95% confidence intervals (CI) were estimated by Cox proportional hazards, adjusted for breast cancer risk factors. Because the oral microbiome of those with periodontal disease differs with smoking status, we examined associations stratified by smoking. RESULTS 2,124 incident, invasive breast cancer cases were identified after mean follow-up of 6.7 years. Periodontal disease, reported by 26.1% of women, was associated with increased breast cancer risk (HR 1.14; 95% CI, 1.03-1.26), particularly among former smokers who quit within 20 years (HR 1.36; 95% CI, 1.05-1.77). Among current smokers, the trend was similar (HR 1.32; 95% CI, 0.83-2.11); there were few cases (n = 74) and the CI included the null. The population attributable fraction was 12.06% (95% CI, 1.12-21.79) and 10.90% (95% CI, 10.31-28.94) for periodontal disease among former smokers quitting within 20 years and current smokers, respectively. CONCLUSION Periodontal disease, a common chronic inflammatory disorder, was associated with increased risk of postmenopausal breast cancer, particularly among former smokers who quit in the past 20 years. IMPACT Understanding a possible role of the oral microbiome in breast carcinogenesis could impact prevention.
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Affiliation(s)
- Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York.
| | - Robert J Genco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Xiaodan Mai
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Ngozi Nwizu
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Christopher A Andrews
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
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Anic GM, Madden MH, Sincich K, Thompson RC, Nabors LB, Olson JJ, LaRocca RV, Browning JE, Pan E, Egan KM. Early life exposures and the risk of adult glioma. Eur J Epidemiol 2013; 28:753-8. [PMID: 23681776 DOI: 10.1007/s10654-013-9811-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
Abstract
Exposure to common infections in early life may stimulate immune development and reduce the risk for developing cancer. Birth order and family size are proxies for the timing of exposure to childhood infections with several studies showing a reduced risk of glioma associated with a higher order of birth (and presumed younger age at infection). The aim of this study was to examine whether birth order, family size, and other early life exposures are associated with the risk of glioma in adults using data collected in a large clinic-based US case-control study including 889 glioma cases and 903 community controls. A structured interviewer-administered questionnaire was used to collect information on family structure, childhood exposures and other potential risk factors. Logistic regression was used to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for the association between early life factors and glioma risk. Persons having any siblings were at significantly lower risk for glioma when compared to those reporting no siblings (OR=0.64; 95% CI 0.44-0.93; p=0.020). Compared to first-borns, individuals with older siblings had a significantly lower risk (OR=0.75; 95% CI 0.61-0.91; p=0.004). Birth weight, having been breast fed in infancy, and season of birth were not associated with glioma risk. The current findings lend further support to a growing body of evidence that early exposure to childhood infections reduces the risk of glioma onset in children and adults.
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Affiliation(s)
- Gabriella M Anic
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA
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Yoshida K, Furumoto H, Abe A, Kato T, Nishimura M, Kuwahara A, Maeda K, Matsuzaki T, Irahara M. The possibility of vertical transmission of human papillomavirus through maternal milk. J OBSTET GYNAECOL 2012; 31:503-6. [PMID: 21823849 DOI: 10.3109/01443615.2011.570814] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Human papillomavirus (HPV) DNA has been detected in the oral cavity of infants and breast cancer tissue, suggesting its vertical transmission through maternal milk. We determined whether HPV is detected in maternal milk and is vertically transmitted by breast-feeding. Informed consent was obtained, and maternal milk samples (n=80) were analysed for high-risk HPV DNA. In 43 women, this DNA was measured in the uterine cervix. In women with positive samples, this DNA was measured in the oral cavities of their children. The domain including HPV E6 and E7 was amplified by polymerase chain reaction using consensus primers, and HPV serotype determined by electrophoresis after restriction enzyme digestion. High-risk HPV-16 was detected in two of 80 samples (2.5%), and in these two cases, high-risk HPV was not detected in the uterine cervix or oral cavity of the child. It was concluded that the infection of HPV in maternal milk is rare (2/80); vertical transmission through maternal milk was not detected in this study (0/80). HPV infection through maternal milk may occur, but its likelihood is low.
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Affiliation(s)
- K Yoshida
- Department of Obstetrics and Gynecology, The University of Tokushima Graduate School, Tokushima, Japan.
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Incidence of Trypanosoma cruzi transmission through breastfeeding during acute experimental Chagas disease. Braz J Infect Dis 2011. [DOI: 10.1016/s1413-8670(11)70155-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Human papillomavirus (HPV) testing of 223 breast milk samples 3 days postpartum was performed with polymerase chain reaction, hybridization, and sequencing. HPV-16-DNA was detected in 4.0% of the samples. HPV carriage in the breast milk was not correlated with mother's oral or cervical HPV-status or the demographic data. Oral HPV-infection of the spouse at month 6 and 12 postpartum was statistically significantly associated with HPV carriage in the breast milk.
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Affiliation(s)
- Marja Sarkola
- MediCity Research Laboratory, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland
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Musiime V, Ssali F, Kizito H, Kityo C, Mugyenyi P. Need for review of prevention of mother-to-child transmission practice especially in discordant couples: a case of mother-to-child transmission of HIV during breast feeding by a mother who tested HIV negative antenatally. AIDS 2007; 21:1658-9. [PMID: 17630569 DOI: 10.1097/qad.0b013e32826fb7d8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kulakac O, Oncel S, Meydanlioglu A, Muslu L. The opinions of employed mothers about their own nutrition during lactation: A questionnaire survey. Int J Nurs Stud 2007; 44:589-600. [PMID: 16638614 DOI: 10.1016/j.ijnurstu.2006.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Revised: 03/03/2006] [Accepted: 03/04/2006] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The main purpose of the study was to identify the changes employed mothers of infants aged 0-24 months made in their nutrition with the aim of increasing their milk production and extending their breastfeeding period. METHODS The 135 full-time employed mothers enrolled in this study came to the Well-Child Clinic at Akdeniz University Hospital. Dietary data were collected from the mothers via a questionnaire prepared by the researchers to elicit details about what kind of foods or nutrition supplements women added, avoided or were recommended to avoid or add to their diets and why. RESULTS All the mothers made changes in their diets while breastfeeding. The number one change that mothers made in their diet in order to increase milk production was to increase their fluid intake (38.6%) while the second was to increase their consumption of sweets (25.3%). The main type of food mothers were advised to avoid were dried legumes and grains (28.9%). The most important reason for this was the belief that they increased the chance of newborn colic (89.4%). There were statistically significant differences between foods avoided by breastfeeding mothers related to their age (chi(2)=6.88, p=.009), education level and those who mentioned increasing their consumption of fluid while breastfeeding (chi(2)=13.12, p=.000). CONCLUSIONS All of the mothers espoused specific practices, and had been given recommendations by others about their nutrition while breastfeeding. Mothers need to be informed about the factors that increase and decrease milk production and affect infant colic, and should be encouraged that they can successfully breastfeed without increasing their consumption of sweets or avoiding dried legumes and some vegetables.
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Affiliation(s)
- Ozen Kulakac
- Akdeniz Universitesi Antalya Saglik Yuksekokulu, Dumlupinar Bulvari 07058 Kampus Antalya, Türkiye.
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Hanson LÅ, Korotkova M, Telemo E. Human Milk: Its Components and Their Immunobiologic Functions. Mucosal Immunol 2005. [DOI: 10.1016/b978-012491543-5/50108-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
The process of lactation and feeding, referred to by some as the final stage of labour is remarkably successful. This phase of infant care has been subjected to considerable evolutionary pressure since the earliest mammals, reptiles and birds diversified. It has allowed thousands of species to occupy a vast range of ecological niches. Yet a significant complication of breast feeding remains inflammation of the lactating tissue: the pathology of mastitis. Mastitis rarely develops outside lactation, although it may affect individuals at any age in relation to congenital lesions such as duct ectasia, chronic disseminated infections such as tuberculosis, or during granulomatous, autoimmune or malignant processes. The immunology and consequences of mastitis as well as its impact on vertical transmission of infection require careful examination.
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Affiliation(s)
- C Michie
- Department of Paediatrics, Ealing Hospital NHS Trust.
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