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Antiretroviral Therapy Effective In Reducing Mother-to-child HIV-1 Transmission When Started After Childbirth (p 1171)
October 08, 2003Results of a study from Malawi in this week's issue of THE LANCET highlight how antiretroviral therapy targeted at babies soon after childbirth (because their mothers' HIV diagnosis was made around the time of delivery) is still effective in preventing vertical HIV-1 transmission from mothers to their children.
Zidovudine and nevirapine have been shown to reduce mother-to-child transmission of HIV in breastfeeding women in Africa; treatment is usually initiated late in pregnancy and continued until early infancy. Taha E Taha from Johns Hopkins Bloomberg School of Public Health, USA and colleagues assessed whether nevirapine and zidovudine given to babies only reduced HIV-1 transmission more than nevirapine alone.
Over 1100 babies of Malawian women with HIV-1 who presented late (within 2 hours of expected delivery) were randomly assigned either nevirapine alone or nevirapine and zidovudine. Both drugs were given immediately after birth. Infant HIV infection was determined at birth and at 6-8 weeks.
The rate of mother-to-child transmission at 6-8 weeks was lower among babies given combination therapy (around 15%) than those given nevirapine alone (around 21% transmission rate). Of babies who were HIV-1 negative at birth, 7.7% of babies given combination therapy were HIV-1 positive at 6-8 weeks compared with 12.1% of babies given nevirapine alone (a protective efficacy of 36%).
Taha E Taha comments: "Postexposure prophylaxis could be a way of reaching babies of women who missed opportunities to be counselled and tested before or during pregnancy. The combined regimen of nevirapine and zidovudine that we studied is easy to implement and might be a candidate for wider use to prevent transmission of HIV from mothers to babies. In settings such as sub-Saharan Africa where most women arrive to the labour room without knowledge of their HIV status, and are too late to receive intrapartum nevirapine, a practical approach would be to test cord blood to identify HIV positive women, to administer nevirapine, and to start zidovudine prophylaxis."
Lancet
The rate of mother-to-child transmission at 6-8 weeks was lower among babies given combination therapy (around 15%) than those given nevirapine alone (around 21% transmission rate). Of babies who were HIV-1 negative at birth, 7.7% of babies given combination therapy were HIV-1 positive at 6-8 weeks compared with 12.1% of babies given nevirapine alone (a protective efficacy of 36%).
Taha E Taha comments: "Postexposure prophylaxis could be a way of reaching babies of women who missed opportunities to be counselled and tested before or during pregnancy. The combined regimen of nevirapine and zidovudine that we studied is easy to implement and might be a candidate for wider use to prevent transmission of HIV from mothers to babies. In settings such as sub-Saharan Africa where most women arrive to the labour room without knowledge of their HIV status, and are too late to receive intrapartum nevirapine, a practical approach would be to test cord blood to identify HIV positive women, to administer nevirapine, and to start zidovudine prophylaxis."
Lancet
HIV Current Events and HIV News RSSMany pregnant women avoid HIV screening in Africa
'Prevention is the best cure' is a common expression, but what happens if preventative measures are not used? A large proportion of pregnant Ugandan women are going out of their way not to be HIV tested, increasing the risk of mother-to-child transmission.
An atomic-level look at an HIV accomplice
Since the discovery in 2007 that a component of human semen called SEVI boosts infectivity of the virus that causes AIDS, researchers have been trying to learn more about SEVI and how it works, in hopes of thwarting its infection-promoting activity.
New findings suggest strategy to help generate HIV-neutralizing antibodies
New discoveries about anti-HIV antibodies may bring researchers a step closer to creating an effective HIV vaccine, according to a new paper co-authored by scientists at the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
Research calls for better assessment of tests for tuberculosis, HIV/AIDS and malaria
A rapid and accurate diagnosis is the first step towards treatment in the fight against infectious disease.
No-entry zones for AIDS virus
The AIDS virus inserts its genetic material into the genome of the infected cell. Scientists of the German Cancer Research Center have now shown for the first time that the virus almost entirely spares particular sites in the human genetic material in this process. This finding may be useful for developing new, specific AIDS drugs.
Hoping for a fluorescent basket case
Although recent advances have raised hopes that a protective vaccine can be developed, acquired immunodeficiency syndrome (AIDS) remains a major public health problem.
Scientists explain binding action of 2 key HIV antibodies; could lead to new vaccine design
A very close and detailed study of how the most robust antibodies work to block the HIV virus as it seeks entry into healthy cells has revealed a new direction for researchers hoping to design an effective vaccine.
U.S. and European Experts Applaud Creation of New Transatlantic Task Force on Global Antibiotic Resistance Threat
Experts on both sides of the Atlantic applaud President Barack Obama and Swedish Prime Minister Fredrik Reinfeldt, representing the European Union (EU) Presidency, for establishing a transatlantic task force to address antibiotic resistance, an urgent and growing problem that threatens patient safety and public health worldwide.
1930s drug slows tumor growth
Drugs sometimes have beneficial side effects. A glaucoma treatment causes luscious eyelashes. A blood pressure drug also aids those with a rare genetic disease.
Indiana U. at APHA: Studies about why men and women use lubricants during sex
An Indiana University study involving 2,453 women ages 18 to 68 found that lubricant use during sexual activity alone or with a partner contributed to higher ratings of pleasurable and satisfying sex.
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