Pediatr Res. 2004 Oct;56(4):529-35. Epub 2004 Aug 4.C
Comment in:
Pediatr Res. 2004 Oct;56(4):526-8.
Cytomegalovirus (CMV) inactivation in breast milk: reassessment of
pasteurization and freeze-thawing.
* Hamprecht K,
* Maschmann J,
* Muller D,
* Dietz K,
* Besenthal I,
* Goelz R,
* Middeldorp JM,
* Speer CP,
* Jahn G.
Institute of Medical Virology and Epidemiology of Viral Diseases,
University Hospital of Tubingen, Elfriede-Aulhorn-Strasse 6, 72076
Tubingen, Germany. [log in to unmask]
Breast-feeding mothers frequently transmit cytomegalovirus (CMV) to
preterm infants of very low birth weight. Current recommendations for
prevention of virus transmission are based on data published 20 y ago in
the context of human milk banking. Two recent clinical trials examined
storage of breast milk at -20 degrees Celsius to reduce virus
transmission. However, in both studies, CMV transmission occurred. Using
sensitive tools like quantitative PCR, CMV pp67 late mRNA assay, and a
high-speed, centrifugation-based microculture assay for quantification
of CMV infectivity, we reassessed the virological and biochemical
characteristics of freeze-storing breast milk at -20 degrees Celsius,
compared it with traditional Holder pasteurization (30 min at 62.5
degrees Celsius), and a new short-term pasteurization (5 s at 72 degrees
Celsius) based on the generation of a milk film. Both heat treatment
procedures were able to destroy viral infectivity and pp67 RNA
completely. Preliminary results showed short-term heat inactivation
below 72 degrees Celsius was less harmful in reducing the activity of
marker enzymes than Holder pasteurization. Freezing breast milk
preserved the biochemical and immunologic quality of the milk; however,
late viral RNA and viral infectivity was also preserved. Compared with
viral DNA, CMV-RNA more directly reflects infectious CMV in human milk
samples. Further studies are necessary to evaluate short-term heat
treatment below 72 degrees Celsius as an effective tool for prevention
of CMV transmission.
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