WHEN HIV IS NOT DIAGNOSED until a pregnant woman with the virus goes into labor, her infant is usually treated soon after birth with the anti-HIV drug zidovudine (ZDV) to prevent the baby from becoming infected. Now, a National Institutes of Health study has found that adding one or two drugs to the standard ZDV treatment can reduce the chances by more than 50 percent that an infant will develop an HIV infection.
The study was conducted at 19 research hospitals in South America, Africa and the United States, under contract to the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
From 100 to 200 infants are born with HIV in the U.S. each year, many to women who either were not tested in early pregnancy or who did not receive treatment during pregnancy. Internationally, estimates of HIV testing vary, with only 21 percent of pregnant women in low- and middle-income countries having been tested during pregnancy.
Infants in the study born to women whose HIV was not diagnosed until they were in labor, and who were treated after their birth with the routine six-week course of ZDV plus three doses of nevirapine (NVP) during the first week of life or with ZDV plus two weeks of lamivudine and nelfinavir, were more than 50 percent less likely to be infected with HIV than those infants who received ZDV alone.
“Our results showed conclusively that the two- and three-drug regimens are superior to the standard treatment with zidovudine,” says the study’s chair, Karin Nielsen-Saines, M.D., clinical professor of pediatrics in the division of infectious diseases at the David Geffen School of Medicine at UCLA and a member of the UCLA AIDS Institute.