Aflatoxin M1 and Ochratoxin A exposure via breast milk and potential risks in HIV-exposed and HIV-unexposed infants from Harare, Zimbabwe

What is it about?

Infants from resource-limited and high-HIV-prevalence settings may be exposed to potentially genotoxic and carcinogenic aflatoxin M1 (AFM1) and OTA via breast milk (BM) consumption. We conducted a retrospective cross-sectional study to assess the levels of exposure to aflatoxin M1 (AFM1) and ochratoxin A (OTA) and potential risks via BM consumption in six-week-old HIV-exposed-infected (HEI), HIV-exposed-uninfected (HEU) and HIV-unexposed-uninfected (HUU) infants from Harare, Zimbabwe. Among all the infants, 66/226 (29%) consumed AFM1 at a median concentration of 7.36 pg/mL (Range: 5.96-31.75), whereas 15/262 (6%) consumed OTA at a median concentration of 0.21 ng/mL (PDI: 0.14-0.83). Among all the infants, the median probable daily intake (MPDI) of AFM1 was 1.2 ng/kg BW/day at a probable daily intake (PDI) ranging from 0.77-5.29 ng/kg BW/day. Among all the infants, the MPDI of OTA was 33.57 ng/kg BW/day at a PDI ranging from 18.97-138.54 ng/kg BW/day. In all infants exposed to AFM1 and OTA, the margin of exposure was <10,000 indicating exposure at levels that are potentially genotoxic and carcinogenic. The exposure of breastfeeding mothers to mycotoxins should be minimised to protect vulnerable infants.

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