The Body Covers: The 12th International AIDS Conference
Worldwide Issues on HIV/AIDS
Briefing on the Journal of the American Medical Association's HIV/AIDS Issue
June 27, 1998
On the eve of the opening of the 12th World AIDS Conference in Geneva, the American Medical Association held a day-long briefing on the research presented in the July 1st, "all-HIV" edition of JAMA. The briefing allowed the researchers whose work is being published to present information in lay terms to the press and public. Two key presentations covered:
At the last international AIDS conference in 1996 in Vancouver, Dr. Gulick presented early (24-week) data from this study of AZT, 3TC and the protease inhibitor indinavir (Crixivan) that showed the world how encouraging triple combination therapy could be. Now, this study of 97 patients has the longest follow-up to date of a combination HIV drug regimen.
This important presentation of two-year data from the study (known as Protocol 035) included the following points:
In this study of 2,834 pairs of mothers and infants, this French study team found that HIV-positive pregnant women may have the best chance of preventing transmission of HIV to their baby by having an elective cesarean section (before the beginning of contractions and labor), using AZT while pregnant, and receiving intravenous AZT during delivery.
This study found that:
Earlier studies conducted in the United States have shown that AZT use during pregnancy does reduce the likelihood of HIV transmission from mother to child. The analysis of this study suggests that C-section and AZT therapy complement each other by protecting the baby at various stages of the gestation and birth process: during pregnancy, during the beginning of labor, and during delivery, when a great deal of blood is often present.
This study pointed out that a C-section is still major surgery, and may pose a significant risk to the mother, but it is a remarkably effective option that HIV-positive women who want to have a child may wish to discuss with their obstetricians.
ReferencesAbstract: Simultaneous vs. Sequential Initiation of Therapy with Indinavir (Crixivan), Zidovudine (AZT) and Lamuvidine (3TC) for HIV Infection: 100 Week Follow-Up
Authored by: Roy Gulick, M.D., M.P.H.
Abstract: Perinatal HIV-1 Transmission: Interaction between Zidovudine Prevention and Mode of Delivery in the French Perinatal Cohort
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