Thai Red Cross zidovudine donation program to prevent vertical transmission of HIV: the effect of the modified ACTG 076 regimen.

Abstract

OBJECTIVES:

To evaluate the impact of the modified ACTG 076 zidovudine regimen on the risk for vertical HIV transmission.

DESIGN:

Observational retrospective evaluation of a prospective cohort.

SETTING:

Thai Red Cross zidovudine donation program to reduce vertical HIV transmission.

PATIENTS:

HIV-infected Thai women and their offspring.

INTERVENTION:

The modified regimen consisted of 500 mg zidovudine daily during pregnancy and 300 mg zidovudine every 3 h during labor, taken orally, and 2 mg/kg zidovudine syrup four times daily for 6 weeks to infants.

MAIN OUTCOME MEASURES:

Only infants with at least 1 HIV DNA polymerase chain reaction (PCR) result at age > or = 4 weeks were included. HIV infection was defined by having at least one positive PCR at age > or = 4 weeks. The transmission rate was calculated. Characteristics of women who did and did not transmit HIV to infants were compared.

RESULTS:

A total of 2891 women and their infants participated in the program and 726 infants of 719 women were included in the analysis. Forty-three infants were infected. The overall transmission rate was 6.0% (95% confidence interval, 4.4-8.0). There were no differences in maternal characteristics between transmitters and non-transmitters. The transmission rate in women who started zidovudine before 30 weeks' gestation was not significantly different from that in women who started zidovudine at or after 30 weeks' gestation: 5.7 versus 3.3%, respectively.

CONCLUSIONS:

This modified zidovudine regimen is effective in reducing vertical transmission in a country with predominant subtype E infection. A donation program for preventing vertical HIV transmission can be implemented in developing countries, as in Thailand.

• Authors: U Thisyakorn, M Khongphatthanayothin, S Sirivichayakul, C Rongkavilit, W Poolcharoen, C Kunanusont, D D Bien, P Phanuphak
• Journal: AIDS (London, England) (AIDS) Vol. 14 Issue 18 Pg. 2921-7 (Dec 22 2000) ISSN: 0269-9370 [Print] England
• PMID: 11153673 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-HIV Agents
• Reverse Transcriptase Inhibitors
• Zidovudine

Topics

• Adult
• Anti-HIV Agents (economics, therapeutic use)
• Chemoprevention
• Female
• HIV Infections (drug therapy, prevention & control, transmission)
• Humans
• Infant, Newborn
• Infectious Disease Transmission, Vertical (prevention & control)
• Pregnancy
• Pregnancy Complications, Infectious (drug therapy, virology)
• Program Evaluation
• Red Cross (economics, organization & administration)
• Reverse Transcriptase Inhibitors (economics, therapeutic use)
• Thailand
• Zidovudine (economics, therapeutic use)