HIV-Positive Mothers Could Potentially Harm Their Infant's Microbiome

Findings from a recent study suggest that HIV-positive mothers could possibly effect microbiome development in HIV-negative infants.

A majority of infants born to HIV-positive mothers do not become infected, but they have a mortality rate twice as high as infants born to HIV-negative mothers. Breastfeeding along with maternal antiretroviral therapy is recommended for HIV-positive mothers who cannot afford an alternative food source for their infants.

Researchers in the study believe that changes in the microbiome and in breast milk’s human milk oligosaccharide (HMO) composition in HIV-positive mothers may negatively affect the microbiome of their infants, according to a study published by Science Translational Medicine. Since HMOs give nutrition to an infant’s microbiome, this component of breast milk helps develop their immune system.

A healthy microbiome can lead to healthy metabolism and immunity, but an unhealthy microbiome could potentially increase morbidity and mortality rates, according to the study. The study included 25 HIV-positive and 25 HIV-negative mothers, and their HIV-negative infants, to examine the microbiomes from each pair.

“In contrast to the mostly consistent microbial communities identified in all of the mothers, the microbiomes of HIV-exposed, uninfected infants were strikingly different from infants born to HIV-negative women in the same community,” said first author Jeffrey M. Bender, MD.

They also found a large difference in the bacterial composition of stool among infants exposed to HIV compared with those who were not exposed. Researchers did not find a large change in bacterial communities between the 2 groups of mothers, which led researchers to believe that dysbiosis, a change in bacterial ecology, was not explained by mother-to-infant transfer.

Findings instead suggest that HMO changes in HIV-positive mothers’ breast milk effected infant microbiomes.

"As a result, the relatively immature and dysbiotic microbiome could potentially compromise development of the infant's immune system," Dr Bender said.

The researchers concluded that providing these infants with probiotics or prebiotics could potentially improve outcomes for HIV-exposed infants.