Nevirapine to Prevent Mother-to-Child HIV Transmission Does Not Undermine Health of Women, Study Says

Nevirapine, the antiretroviral medication that is widely used in Africa to prevent mother-to-child HIV transmission, is safe and does not affect the long-term health of women who take it, according to a study released Wednesday at XVI International AIDS Conference in Toronto, the Birmingham New reports. Previous research in Uganda indicated that taking a single dose of the treatment could create a drug-resistant HIV strain in some women and children who took it, the News reports. For the new study, conducted at the Centre for Infectious Disease Research in Zambia, Benjamin Chi, lead author of the study and an assistant professor at the University of Alabama-Birmingham, examined 4,552 women receiving HIV/AIDS treatment, including 445 women who had used a single dose of nevirapine to prevent mother-to-child HIV transmission. After one year, there was no significant difference in mortality or in serious illnesses between women who had taken nevirapine and those who had not, Chi said. The study did find a potential risk of antiretroviral treatment failure for a small group of women who had begun the treatment fewer than six months after receiving nevirapine. According to Chi, that group of women might have had more advanced cases of HIV/AIDS and should have begun a full antiretroviral regimen before delivering to protect both themselves and their infants. Chi said further research on the subject is needed, but he stressed that pregnant women should be tested more vigilantly for HIV and be provided with effective antiretroviral treatment. The Centre for Infectious Disease Research in Zambia is a partnership between UAB and the Zambian government, and the study was funded by the Elizabeth Glaser Pediatric AIDS Foundation, the News reports. The foundation and CIDRZ have been developing programs on mother-to-child transmission of HIV for the last five years, and they support more than 90 clinics in Zambia (Parks, Birmingham News, 8/17).

Antiretrovirals, Bottle-Feeding Could Reduce Risk of Vertical HIV Transmission, Study Says
A new regimen that combines antiretroviral drugs and bottle-feeding for infants could help reduce the risk of mother-to-child HIV transmission, according to a study presented Thursday at the AIDS conference, AFP/Turkish Press reports. Researchers at the French National Agency for Research on AIDS from 2001 through 2005 studied 808 HIV-positive pregnant women who gave birth to 711 infants in Abidjan, Cote d'Ivoire. Some of the pregnant women were given a combination therapy that included zidovudine, also known as AZT, during the last four weeks of pregnancy and a single dose of nevirapine during labor. The other pregnant women received a combination of AZT and lamivudine in the last eight weeks of pregnancy and a single dose of nevirapine during labor. All of the infants received a dose of nevirapine two days after they were born and AZT for one week. The women either began bottle-feeding the infants immediately or breast-fed the infants for four months. Among the pregnant women who took AZT and lamivudine and bottle-fed their infants, 5.6% of the 126 infants were HIV-positive, according to the study. The researchers found that among the women who took AZT and nevirapine and breast-fed their infants, 15.9% of 169 infants were HIV-positive. "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," Valeriane Leroy of ANRS said. Leroy emphasized that women who are encouraged to bottle-feed their infants need to have access to clean water, as well as bottle-feeding equipment. According to UNAIDS, in 2005, less than 6% of pregnant women in sub-Saharan Africa were offered services to prevent mother-to-child HIV transmission. Without antiretrovirals, a pregnant woman has a 20% to 45% change of giving birth to an HIV-positive infant, the AFP/Press reports (AFP/Turkish Press, 8/17).

Kaisernetwork.org served as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at www.kaisernetwork.org/aids2006.

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