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Salivary Secretory Leukocyte Protease Inhibitor Is Associated with Reduced Transmission of Human Immunodeficiency Virus Type 1 through Breast Milk

Carey Farquhar, Thomas C. VanCott, Dorothy A. Mbori-Ngacha, Lena Horani, Rose K. Bosire, Joan K. Kreiss, Barbra A. Richardson and Grace C. John-Stewart
The Journal of Infectious Diseases
Vol. 186, No. 8 (Oct. 15, 2002), pp. 1173-1176
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30085220
Page Count: 4
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Salivary Secretory Leukocyte Protease Inhibitor Is Associated with Reduced Transmission of Human Immunodeficiency Virus Type 1 through Breast Milk
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Abstract

Secretory leukocyte protease inhibitor (SLPI), a protein found in saliva, breast milk, and genital secretions, is capable of inhibiting human immunodeficiency virus (HIV) type 1 in vitro. The aim of this study was to determine whether SLPI in infant saliva provides protection against mother-to-child HIV-1 transmission. In total, 602 saliva specimens were collected from 188 infants at birth and at ages 1, 3, and 6 months. Infants' median salivary SLPI concentrations were higher at birth than at 6 months (341 vs. 219 ng/mL; P = .001). There was no association between SLPI concentration and HIV-1 transmission overall. However, among 122 breast-fed infants who were HIV-1 uninfected at 1 month, higher salivary SLPI levels were associated with a decreased risk of HIV-1 transmission through breast milk (hazard ratio, 0.5; 95% confidence interval, 0.3-0.9; P = .03). These results suggest that SLPI plays an important role in reducing HIV-1 transmission through breast milk.

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