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December 23, 1988

The Transmission of AIDS: The Case of the Infected Cell

Author Affiliations

University of Florence Italy

University of Florence Italy

JAMA. 1988;260(24):3586-3587. doi:10.1001/jama.1988.03410240044013

To the Editor. —  We read with great interest the article in the May 27 issue of JAMA by Dr Levy1 about the importance of human immunodeficiency virus (HIV)—infected cells in transmission of acquired immunodeficiency syndrome.It has been reported2,3 that the vertical transmission of HIV infection from an infected mother to her newborn is presumptively possible via breast-feeding, owing to the isolation of retrovirus from cell-free human breast milk.4 Although this evidence in no way excludes HIV transmission through the acellular fraction of milk, it does suggest that the risk, if there is one, is likely to be small. This is because of the presence in human milk of a wide range of factors active against free viruses and because oral infection with HIV can occur only in the event of mucosal ruptures. Transmission, therefore, might occur by two different mechanisms: by penetration of retrovirus through