Грудное молоко и оценка риска вертикальной передачи вирусов при грудном вскармливании

Актуальность. Грудное молоко представляет собой жизненно важный источник питания и иммунной защиты новорожденных. Потенциальная угроза передачи различных вирусных инфекций от матери к новорожденному в процессе грудного вскармливания делает проблему вирусного заражения грудного молока актуальной областью исследований.

Цель. Представить на основе зарубежных научных публикаций данные о вирусах, обнаруживаемых в грудном молоке, и, в связи с этим, о риске для здоровья ребенка.

Заключение. Несмотря на возможность присутствия определенных вирусов в грудном молоке, существующие научные данные подтверждают, что в большинстве случаев преимущества грудного вскармливания значительно превышают потенциальные риски, особенно при соблюдении профилактических мер. Таким образом, комплексный подход к оценке рисков и пользы грудного вскармливания является необходимым условием для обеспечения здоровья матери и ребенка.

1. Walker, A. Breast milk as the gold standard for protective nutrients. The Journal of pediatrics, 2010.156 2 Suppl, S3-7. https://doi.org/10.1016/j.jpeds.2009.11.021

2. Cacho, N., & Lawrence, R. (). Innate Immunity and Breast Milk. Frontiers in Immunology, 2017. 8. https://doi.org/10.3389/fimmu.2017.00584.

3. Toscano, M., De Grandi, R., Grossi, E., et al. Role of the Human Breast Milk-Associated Microbiota on the Newborns’ Immune System: A Mini Review. Frontiers in Microbiology. 2017. 8. https://doi.org/10.3389/fmicb.2017.02100.

4. Doare, K., Holder, B., Bassett, A., et al. Mother’s Milk: A Purposeful Contribution to the Development of the Infant Microbiota and Immunity. Frontiers in Immunology. 2018. 9. https://doi.org/10.3389/fimmu.2018.00361.

5. Alotiby, A. (). The role of breastfeeding as a protective factor against the development of the immune-mediated diseases: A systematic review. Frontiers in Pediatrics. 2023. 11. https://doi.org/10.3389/fped.2023.1086999.

6. Nolan, L., Parks, O., Good, M. A Review of the Immunomodulating Components of Maternal Breast Milk and Protection Against Necrotizing Enterocolitis. Nutrients. 2019.12. https://doi.org/10.3390/nu12010014.

7. Breastfeeding and the Use of Human Milk. Доступно на:Available at: https://publications.aap.org/pediatrics/article/129/3/e827/31785/Breastfeeding-and-the-Use-ofHuman-Milk

8. Rousseau, C., Nduati, R., Richardson, B., et al. Longitudinal analysis of human immunodeficiency virus type 1 RNA in breast milk and of its relationship to infant infection and maternal disease. The Journal of infectious diseases. 2003. 187 5, 741–7 . https://doi.org/10.1086/374273.

9. Hino S. Establishment of the milk-borne transmission as a key factor for the peculiar endemicity of human T-lymphotropic virus type 1 (HTLV-1): the ATL Prevention Program Nagasaki. Proc Jpn Acad Ser B Phys Biol Sci. 2011;87(4):152–166. doi: 10.2183/pjab.87.152.

10. Cavalcanti MG, Cabral-Castro MJ, Gonçalves JLS, et al. Zika virus shedding in human milk during lactation. An unlikely source of infection? Int J Infect Dis. 2017;57:70–72. doi: 10.1016/j.ijid.2017.01.042.

11. Bansaccal N, Van der Linden D, Marot JC, Belkhir L. HIV-Infected Mothers Who Decide to Breastfeed Their Infants Under Close Supervision in Belgium: About Two Cases. Front Pediatr. 2020;8:248. doi: 10.3389/fped.2020.00248.

12. Abuogi L, Smith C, Kinzie K, et al. A. Development and Implementation of an Interdisciplinary Model for the Management of Breastfeeding in Women With HIV in the United States: Experience From the Children’s Hospital Colorado Immunodeficiency Program. J Acquir Immune Defic Syndr. 2023;93(5):395–402. doi: 10.1097/ QAI.0000000000003213.

13. Infant feeding for the prevention of mother-to-child transmission of HIV. Доступно на:Available on: https://www.who.int/tools/elena/interventions/hiv-infant-feeding

14. Slyker JA, Chung MH, Lehman DA, et al. Incidence and correlates of HIV-1 RNA detection in the breast milk of women receiving HAART for the prevention of HIV-1 transmission. PLoS One. 2012;7(1):e29777. doi: 10.1371/journal.pone.0029777.

15. Shapiro RL, Ndung’u T, Lockman S, et al. Highly active antiretroviral therapy started during pregnancy or postpartum suppresses HIV-1 RNA, but not DNA, in breast milk. J Infect Dis. 2005;192(5):713–9. doi: 10.1086/432489.

16. Viljoen J, Tuaillon E, Nagot N, et al. Cytomegalovirus, and possibly Epstein-Barr virus, shedding in breast milk is associated with HIV-1 transmission by breastfeeding. AIDS. 2015;29(2):145–53. doi: 10.1097/QAD.0000000000000527.

17. Gantt S, Carlsson J, Shetty AK, et al. Cytomegalovirus and Epstein-Barr virus in breast milk are associated with HIV-1 shedding but not with mastitis. AIDS. 2008;22(12):1453–60. doi: 10.1097/QAD.0b013e32830184f2.

18. Lawrence RM, Lawrence RA. Breast milk and infection. Clin Perinatol. 2004 Aug;31(3):501–28. doi: 10.1016/j.clp.2004.03.019.

19. Boostani R, Sadeghi R, Sabouri A, Ghabeli-Juibary A. Human T-lymphotropic virus type I and breastfeeding; systematic review and meta-analysis of the literature. Iran J Neurol. 2018 Oct 7;17(4):174–9. doi: 10.30476/IJNL.2018.44378.

20. Maschmann J, Hamprecht K, Dietz K, et al. Cytomegalovirus infection of extremely low-birth weight infants via breast milk. Clin Infect Dis. 2001;33(12):1998-2003.

21. Prendergast AJ, Goga AE, Waitt C, et al. Transmission of CMV, HTLV-1, and HIV through breastmilk. Lancet Child Adolesc Health. 2019;3(4):264–273. doi: 10.1016/S23524642(19)30024-0.

22. Capretti, M. G., Lanari, M., Lazzarotto, T., et al. Very Low Birth Weight Infants Born to Cytomegalovirus-Seropositive Mothers Fed with Their Mother’s Milk: A Prospective Study. The Journal of Pediatrics. 2009. 154(6), 842–847. doi:10.1016/j.jpeds.2008.12.046

23. Ómarsdóttir, S., Casper, C., Zweygberg Wirgart, B., et al. Transmission of cytomegalovirus to extremely preterm infants through breast milk. Acta Paediatrica. 2007. 96(4), 492–494.

24. Bardanzellu F, Fanos V, Reali A. Human Breast Milk-Acquired Cytomegalovirus Infection: Certainties, Doubts and Perspectives. Curr Pediatr Rev. 2019;15(1):30–41. doi: 10.21 74/1573396315666181126105812

25. Goelz R, Meisner C, Bevot A, et al. Long-term cognitive and neurological outcome of preterm infants with postnatally acquired CMV infection through breast milk. Arch Dis Child Fetal Neonatal Ed. 2013;98(5):F430–3. doi: 10.1136/archdischild-2012-303384.

26. Neuberger P, Hamprecht K, Vochem M, Maschmann J, et al. . Case-control study of symptoms and neonatal outcome of human milk-transmitted cytomegalovirus infection in premature infants. J Pediatr. 2006;148(3):326–31. doi: 10.1016/j.jpeds.2005.09.030.

27. Pietrasanta C, Ghirardi B, Manca MF, et al. Herpesvirus e latte materno. Pediatric Medicine and Surgery. 2014;36(3):111–5.

28. Yoshida, M., Yamagami, N., Tezuka, T., Hondo, R. Case report: detection of varicella-zoster virus DNA in maternal breast milk. Journal of Medical Virology, 1992. 38(2), 108–110. https://doi.org/10.1002/JMV.1890380207

29. Sanosyan A, Rutagwera DG, Molès J-P, et al. Increased Epstein-Barr virus in breast milk occurs with subclinical mastitis and HIV shedding. Medicine (Baltimore). 2016;95(27):e4005. doi: 10.1097/MD.0000000000004005.

30. Daud II, Coleman CB, Smith NA, et al. Breast Milk as a Potential Source of Epstein-Barr Virus Transmission Among Infants Living in a Malaria-Endemic Region of Kenya. J Infect Dis. 2015;212(11):1735–42. doi: 10.1093/infdis/jiv290.

31. Brayfield, B. P., Kankasa, C., West, J. T., et al. Distribution of Kaposi Sarcoma-Associated Herpesvirus/Human Herpesvirus 8 in Maternal Saliva and Breast Milk in Zambia: Implications for Transmission. The Journal of Infectious Diseases, 2004.189(12), 2260–2270. https://doi.org/10.1086/421119

32. Crabtree, K. L., Wojcicki, J. M., Minhas, V., et al. Risk Factors for Early Childhood Infection of Human Herpesvirus-8 in Zambian Children: The Role of Early Childhood Feeding Practices. Cancer Epidemiology, Biomarkers & Prevention, 2014. 23(2), 300–308. https://doi.org/10.1158/1055-9965.EPI-13-0730

33. Luo Y, Xiang K, Liu J, et al. Inhibition of In Vitro Infection of Hepatitis B Virus by Human Breastmilk. Nutrients. 2022.14(8), 1561. https://doi.org/10.3390/nu14081561

34. Ahmed, A. N. U. Hoque, M. M. Is it safe for a mother infected with hepatitis B virus to breastfeed her baby? Bangladesh Journal of Child Health, 2012. 35(1), 20–25. https://doi.org/10.3329/bjch.v35i1.10369

35. Zhou, M., Li, L., Han, L., et al. Breast-Feeding is Not a Risk Factor of Mother-to-Child Transmission of Hepatitis B Virus. International Journal of General Medicine. 2021. 14, 1819–1827. https://doi.org/10.2147/IJGM.S289804

36. Zheng, Y., Lu, Y., Qi, Y., et al. Should chronic hepatitis b mothers breastfeed? a meta analysis. BMC Public Health. 2011. 11(1). https://doi.org/10.1186/1471-2458-11-502

37. Shi Z, Yang Y, Wang H, et al. Breastfeeding of newborns by mothers carrying hepatitis B virus: a meta-analysis and systematic review. Arch Pediatr Adolesc Med. 2011. Sep;165(9):837–46. doi: 10.1001/archpediatrics.2011.72.

38. Montoya-Ferrer A, Zorrilla AM, Viljoen J, et al. High Level of HBV DNA Virus in the Breast Milk Seems not to Contraindicate Breastfeeding. Mediterr J Hematol Infect Dis. 2015;7(1):e2015042. doi: 10.4084/MJHID.2015.042

39. Xiao, F., Lan, A., Mo, W. Breastfeeding from mothers carrying HBV would not increase the risk of HBV infection in infants after proper immunoprophylaxis. MINERVA Pediatrica. 2020. 72(2), 109–115. https://doi.org/10.23736/S0026-4946.17.04798-3

40. Pfaender S, Heyden J, Friesland M, et al. Inactivation of Hepatitis C Virus Infectivity by Human Breast Milk. J Infect Dis. 2013;208(12):1943–52. doi: 10.1093/infdis/jit519.4

41. Mast, E. E. (). Mother-to-Infant Hepatitis C Virus Transmission and Breastfeeding. 2004. Vol. 554, pp. 211–216. Springer, Boston, MA. https://doi.org/10.1007/978-1-47574242-8_18

42. Zanetti, A., Tanzi, E., Semprini, A. E. Hepatitis C in Pregnancy and Mother-to-Infant Transmission of HCV. 2006. Vol. 13, pp. 153–171. Elsevier. https://doi.org/10.1016/S01687069(06)13009-8

43. Aslan AT, Balaban HY. Hepatitis E virus: Epidemiology, diagnosis, clinical manifestations, and treatment. World J Gastroenterol. 2020;26(37):5543–5560. doi: 10.3748/wjg.v26.i37.5543.

44. Chibber, R. M., Usmani, M. A., Al-Sibai, M. H. Should HEV infected mothers breast feed? Archives of Gynecology and Obstetrics. 2004.270(1), 15–20.

45. Tiwari, P., & Verma, K. K. Transmission of Infectious Diseases Through Breast Milk and Breastfeeding. 2022. pp. 393–456. Elsevier eBooks. https://doi.org/10.1016/b978-0-32368013-4.00012-2

46. Schröter, M., Polywka, S., Zöllner, B., et al. Detection of TT Virus DNA and GB Virus Type C/Hepatitis G Virus RNA in Serum and Breast Milk: Determination of Mother-to-Child Transmission. Journal of Clinical Microbiology. 2000.38(2), 745–747. https://doi.org/10.1128/JCM.38.2.745-747.2000

47. Lin HH, Kao JH, Lee PI, Chen DS. Early acquisition of TT virus in infants: possible minor role of maternal transmission. J Med Virol. 2002;66(2):285–90. doi: 10.1002/jmv.2143.

48. Desgraupes, S., Hubert, M., Gessain, A., et al. Mother-to-Child Transmission of Arboviruses during Breastfeeding: From Epidemiology to Cellular Mechanisms. Viruses 2021; 13:1312.

49. Centeno-Tablante, E., Medina-Rivera, M., Finkelstein, J.L., et al. Update on the Transmission of Zika Virus Through Breast Milk and Breastfeeding: A Systematic Review of the Evidence. Viruses 2021, 13, 123.

50. Francese, R., Civra, A., Donalisio, M., et al. (2020). Anti-Zika virus and anti-Usutu virus activity of human milk and its components. PLOS Neglected Tropical Diseases, 14(10), e0008713.

51. Barthel A, Gourinat A-C, Cazorla C, et al. Breast Milk as a Possible Route of Vertical Transmission of Dengue Virus? Clin Infect Dis. 2013;57(3):415–7. doi: 10.1093/cid/cit227

52. Arragain, L., Dupont-Rouzeyrol, M., O’Connor, O., et al. Vertical Transmission of Dengue Virus in the Peripartum Period and Viral Kinetics in Newborns and Breast Milk: New Data. Journal of the Pediatric Infectious Diseases Society. 2016;6(4):324–331. https://doi.org/10.1093/JPIDS/PIW058

53. Ribeiro AF, Brasil LMC, Prada RM, et al. Detection of Wild-Type Yellow Fever Virus in Breast Milk. Pediatr Infect Dis J. 2020;39(1):68–69. doi: 10.1097/INF.0000000000002496.

54. Hassan, T., Bashir, R., Abdelrahman, D. N., et al.). Transmission of yellow fever vaccine virus from breast feeding mothers to their infants: reporting of yellow fever virus (YFV) RNA detection in milk specimens. F1000Research. 20244 11, 76. https://doi.org/10.12688/f1000research.74576.4

55. Traiber C., Coelho-Amaral P., Ritter V.R.F., Winge A. Infant meningoencephalitis probably caused by yellow fever vaccine virus transmitted via breastmilk. J. Pediatr. 2011;87:269–272. doi: 10.2223/JPED.2067.

56. Hinckley, A. F., O’Leary, D. R., Hayes, E. B. Transmission of West Nile virus through human breast milk seems to be rare. Pediatrics. 2007;119(3). https://doi.org/10.1542/PEDS.2006-2107

57. Miao, Y., Zheng, Y., Wang, T., et al. Breast milk transmission and involvement of mammary glands in tick-borne flavivirus infected mice. Journal of Virology. 20244e0170923. https://doi.org/10.1128/jvi.01709-23

58. Kerlik, J., Avdicova, M., Musilová, M., et al. Breast Milk as Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant. Emerging Infectious Diseases. 2022;28(5), 1060–1061. https://doi.org/10.3201/eid2805.212457

59. Martello, E., Gillingham, E. L., Phalkey, R., et al. Systematic review on the non-vectorial transmission of Tick-borne encephalitis virus (TBEV). Ticks and Tick-borne Diseases. 2022;13, 102028.

60. He, Y., Liu, J., Hu, X., Li, H., et al. Breastfeeding vs. breast milk transmission during COVID-19 pandemic, which is more important? Frontiers in Pediatrics. 2023https://doi.org/10.3389/fped.2023.1253333

61. Coronavirus disease (COVID-19): Pregnancy, childbirth and the postnatal period. Доступно на:Available at: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-pregnancy-and-childbirth

62. Medina-Rivera, M., Centeno-Tablante, E., Finkelstein, J. L., et al. Presence of Ebola virus in breast milk and risk of mother-to-child transmission: synthesis of evidence. Annals of the New York Academy of Sciences. 2021;1488(1), 33–43. https://doi.org/10.1111/NYAS.14519

63. Bower H, Johnson S, Bangura MS, et al. Effects of Mother’s Illness and Breastfeeding on Risk of Ebola Virus Disease in a Cohort of Very Young Children. PLoS Negl Trop Dis. 2016;10(4):e0004622. https://doi.org/10.1371/journal.pntd.0004622

64. Ferrés, M., Martínez-Valdebenito, C., Angulo, J., et al. Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile. Emerging Infectious Diseases. 2020;26(8), 1885–1888. https://doi.org/10.3201/EID2608.200204

65. Bellomo, C., Alonso, D., Coelho, R., et al. A newborn infected by Andes virus suggests novel routes of hantavirus transmission: a case report. Clinical Microbiology and Infection. 2020;26(1), 130–131.

66. Louvanto K, Sarkola M, Rintala M, et al. Breast Milk Is a Potential Vehicle for Human Papillomavirus Transmission to Oral Mucosa of the Spouse. Pediatr Infect Dis J. 2017 Jul;36(7):627–630. doi: 10.1097/INF.0000000000001546.

67. Perre, P., Molès, J.-P., Rollins, N. Is monkeypox virus transmissible by breastfeeding? Pediatric Allergy and Immunology. 2022;33(10). https://doi.org/10.1111/pai.13861

68. da Silva, K., Barroso Guedes-Granzotti, R., Hernandez Alves Ribeiro César, C. P., et al. Emerging Challenges of Mpox Transmission: An In-depth Scoping Review and Evidence Mapping on Breastfeeding Practices in South America. Pediatric Infectious Disease Journal. 2024. https://doi.org/10.1097/inf.0000000000004432

69. Powell E, Sumner E, Shaw AG, et al. The temporal pattern and lifestyle associations of respiratory virus infection in a cohort study spanning the first two years of life. BMC Pediatr. 2022;22(1):166. doi: 10.1186/s12887-022-03215-3.