New Regimen Slashes Mother-to-Child HIV Risk: Study

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.

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