New Regimen Slashes
Mother-to-Baby HIV Risk: Study
Agence France
Presse
Isabel Parenthoen
(08.17.06)
According to a study presented Thursday at the 16th International AIDS
Conference, the risk of mother-to-child HIV/AIDS transmission can be greatly
reduced by combining drug treatment at the end of pregnancy and during delivery
with alternatives to long-term breast feeding. Doctors with the French National
Agency for Research on AIDS (ANRS) discussed the study, which was conducted from
2001 to 2005 in Abidjan, Ivory Coast. Without antiretrovirals, HIV-positive
mothers stand a 20-45 percent chance of transmitting the virus to the babies.
The study included 808 HIV-positive women who gave birth to 711 babies. The
prenatal drug cocktail was either zidovudine (AZT) during the last four weeks of
pregnancy and a single dose of nevirapine at the moment of labor, or a double
therapy of AZT and lamivudine (3TC) during the last eight weeks of pregnancy
combined with a single dose of nevirapine during labor.
Each baby received a dose of nevirapine two days after birth, and AZT for one
week. The mothers either started bottle-feeding at birth or exclusively nursed
their babies for only four months. The study found the best combination was AZT
and 3TC with bottle feeding. Of the 126 infants in that regimen, 5.6 percent
contracted HIV. The least successful regimen was AZT and nevirapine followed by
short-term breast feeding: 15.9 percent of 169 babies in this regimen became
infected.
"This is the first demonstration in Africa of the benefit of managing HIV-infected pregnant women with a combination of antiretroviral treatment and alternatives to prolonged maternal feeding," said Valeriane Leroy of ANRS. Leroy stressed, however, that if poor, infected mothers were encouraged to bottle-feed their babies for such long periods, they must have access to clean water and baby formula.