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The Body Covers: The 35th Annual Meeting of the Infectious Diseases Society of America
Maternal Viral Genotypic Zidovudine (ZDV) Resistance and Infrequent Failure of ZDV Therapy to Prevent Perinatal Transmission
September 1997 Dr. Robert Coombs of the University of Washington presented data from
the ACTG 076 study of the use of antiretroviral therapy in preventing HIV
transmission which suggested that AZT resistance was not associated with HIV
transmission. In this study, the women were generally antiretroviral naive
(92%) prior to their pregnancy and did not receive AZT until the start of
their third trimester. None of the women had high level AZT resistance
develop in the course of the protocol and only 14% developed any resistance
at the time of delivery. Low level resistance was not associated with an
increased risk of HIV transmission in this study.
The different results in the Welles and Coombs studies may be explained by the fact that the women in the Welles study were more immunosuppressed and had a prior AZT experience for the most part, while the women in the Coombs study were usually AZT-naive. The studies suggest that pregnant women who have progressive HIV infection, and who are AZT-experienced, will need regimens containing other nucleosides in order to minimize perinatal HIV transmission.
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