HIV-specific functional antibody responses in breast milk mirror those in plasma and are primarily mediated by IgG antibodies.

Journal Article (Journal Article)

Despite months of mucosal virus exposure, the majority of breastfed infants born to HIV-infected mothers do not become infected, raising the possibility that immune factors in milk inhibit mucosal transmission of HIV. HIV Envelope (Env)-specific antibodies are present in the milk of HIV-infected mothers, but little is known about their virus-specific functions. In this study, HIV Env-specific antibody binding, autologous and heterologous virus neutralization, and antibody-dependent cell cytotoxicity (ADCC) responses were measured in the milk and plasma of 41 HIV-infected lactating women. Although IgA is the predominant antibody isotype in milk, HIV Env-specific IgG responses were higher in magnitude than HIV Env-specific IgA responses in milk. The concentrations of anti-HIV gp120 IgG in milk and plasma were directly correlated (r = 0.75; P < 0.0001), yet the response in milk was 2 logarithm units lower than in plasma. Similarly, heterologous virus neutralization (r = 0.39; P = 0.010) and ADCC activity (r = 0.64; P < 0.0001) in milk were directly correlated with that in the systemic compartment but were 2 log units lower in magnitude. Autologous neutralization was rarely detected in milk. Milk heterologous virus neutralization titers correlated with HIV gp120 Env-binding IgG responses but not with IgA responses (r = 0.71 and P < 0.0001, and r = 0.17 and P = 0.30). Moreover, IgGs purified from milk and plasma had equal neutralizing potencies against a tier 1 virus (r = 0.65; P < 0.0001), whereas only 1 out of 35 tested non-IgG milk fractions had detectable neutralization. These results suggest that plasma-derived IgG antibodies mediate the majority of the low-level HIV neutralization and ADCC activity in breast milk.

Full Text

Duke Authors

Cited Authors

  • Fouda, GG; Yates, NL; Pollara, J; Shen, X; Overman, GR; Mahlokozera, T; Wilks, AB; Kang, HH; Salazar-Gonzalez, JF; Salazar, MG; Kalilani, L; Meshnick, SR; Hahn, BH; Shaw, GM; Lovingood, RV; Denny, TN; Haynes, B; Letvin, NL; Ferrari, G; Montefiori, DC; Tomaras, GD; Permar, SR; Center for HIV/AIDS Vaccine Immunology,

Published Date

  • September 2011

Published In

Volume / Issue

  • 85 / 18

Start / End Page

  • 9555 - 9567

PubMed ID

  • 21734046

Pubmed Central ID

  • PMC3165739

Electronic International Standard Serial Number (EISSN)

  • 1098-5514

Digital Object Identifier (DOI)

  • 10.1128/JVI.05174-11


  • eng

Conference Location

  • United States