Antiretroviral therapy after birth decreases mother-to-child HIV transmission

October 09, 2003

Antiretroviral therapy given to babies after birth offers protection against HIV infection, according to researchers from the Johns Hopkins Bloomberg School of Public Health.

They found that a regimen of nevirapine and zidovudine is 36 percent effective in blocking the transmission of HIV from mother to child. The researchers also report that giving these drugs to babies after birth is easier to administer when compared to giving antiretrovirals to mothers during pregnancy. <>p>"Short post-exposure prophylaxis in newborn babies to reduce mother-to-child transmission of HIV-1; NVAZ randomized clinical trial" is published in the October 11, 2003, issue of The Lancet.

Lead author Taha El Tahir Taha, MBBS, PhD, MPH, MCM, associate professor in the School's Department of Epidemiology, with a joint appointment in the Department of Population and Family Health Sciences, explained that nevirapine is typically given to mothers prior to delivery and to the baby after birth to prevent mother-to-child transmission of HIV. In Sub-Saharan Africa, most women arrive at medical facilities only a few hours before delivery and with an unknown HIV status, making it difficult to counsel them and test for HIV.

He said, "These factors limit the use of nevirapine before delivery. Another approach to prevent transmission of the disease is clearly necessary. In this study, we've shown that exposure after birth to prophylaxis with nevirapine and AZT can reduce mother-to-child transmission of HIV."

The researchers studied babies from 1,119 Malawian women with HIV-1 who presented late for delivery to determine if treatment with a combination of nevirapine and zidovudine as compared to a regimen of nevirapine alone reduced transmission of the disease. Infant HIV was tested at birth from cord blood samples and at 6-8 weeks. At the 6-8 week mark for babies who were HIV negative at birth, the protection rate was 7 percent for the 484 babies who received nevirapine and zidovudine and 12 percent for the 468 babies who received nevirapine only. The net reduction of overall mother-to-child transmission was five percent. These results are comparable to rates observed in studies in South Africa and Uganda, where antiretroviral drugs were given to both mother and infant.

The researchers also explain in their study that a regimen of nevirapine and zidovudine is easily given to babies orally immediately after birth a single dose of nevirapine followed by zidovudine twice a day for seven days. Giving post-exposure prophylaxis only to the baby is also easier than giving antiretrovirals to pregnant women and their newborns, especially in areas where resources are scare.

Dr. Taha said, "When it is not possible to give intrapartum nevirapine to the mother, it is still beneficial to give the intervention to the baby after birth. The baby will be afforded additional protection by receiving a second antiviral drug. With these new, promising results, we believe that alternative drugs may also be used as safety data become available. These regimens could also be extended to prevent transmission of HIV through breast milk."

Newton I. Kumwenda and Amanda Gibbons, both with the Johns Hopkins Bloomberg School of Public Health, co-authored the study. Additional co-authors were Robin L. Broadhead, Susan Fiscus, Valentino Lema, George Liomba, Chiwawa Nkhoma, Paolo G. Miotti and Donald R. Hoover.
-end-
Research was supported by grants from the Fogarty International Center, National Institutes of Health and the Doris Duke Charitable Foundation, N.Y.
News releases from the Johns Hopkins Bloomberg School of Public Health are available at http://www.jhsph.edu/Press_Room.

Johns Hopkins University Bloomberg School of Public Health

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.