AIDS Drugs During Pregnancy Don't Harm Fetus, Study Finds

American doctors routinely prescribe antiretroviral drug cocktails to pregnant women infected with HIV despite nagging fears that the medicines might result in premature or low birth-weight babies. But those fears are largely unfounded, according to a study made public today. The study involving 3,266 expectant mothers infected with the virus found that those who took the drug cocktails were no more likely to give birth to premature or low birth weight babies than those who did not.

"There was always this little back-of-the-mind concern," said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, one of two branches at the National Institutes of Health that paid for the research. "A chance was taken in treating those women. This study shows that, in retrospect, it was a good decision," Fauci said. The study in the current issue of the New England Journal of Medicine (06.13.02;346;24:1863-1870), did however, suggest an association between protease inhibitors and very low-birth weight babies. But authors said that finding, based on data on a small subset of women in the study, was not solid and required further study. It is possible, Dr. Ruth E. Tuomala, lead author of the study and an obstetrician/gynecologist at Brigham and Women's Hospital in Boston, said that only the sickest women were treated with protease inhibitors, and that "the severity of the illness is responsible for the lower birthweight, as opposed to the drug itself."

The CDC estimates that 6,000 HIV-infected women give birth every year and that 300 to 400 babies are born with the virus in the United States. One of the biggest public health successes of the AIDS epidemic has been the use of antiretroviral medicines to reduce the spread of the virus from mothers to infants. Experts say the study is not likely to change medical practice, which has been to treat HIV-infected expectant mothers as if they were not pregnant, on the theory that taking care of the disease is best for both mother and child.

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