The search to understand the counterintuitive but consistent finding that exclusive breast-feeding is associated with a lower risk of postnatal mother-to-infant transmission of human immunodeficiency virus (HIV) than is mixed feeding continues without a clear or convincing resolution [1—5], Detailed insight into the mechanism(s) underlying this repeated observation would hopefully allow effective intervention. Babies receiving mixed feedings may develop more frequent or severe enteric infections [6-10], allowing less ingested HIV to be more efficiently infectious. Foods other than breast milk may differentially alter gastric pH and other alimentary defenses against HIV in the gastrointestinal tract of exposed infants.
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