Children are the unfortunate victims of HIV that is
transmitted from the HIV-infected mother while the baby is in the uterus or
during childbirth. Some studies have indicated that administering an anti-HIV
drug zidovudine within 48 hours of birth to the infant and continuing it for 6
weeks reduces transmission of HIV to the infant during childbirth, though this
treatment may not work in 12 to 26% cases.
Researchers conducted a study to evaluate if
addition of other antiretroviral drugs to zidovudine could possibly reduce the
chances of transmission of HIV infection from the mother to the baby in cases
where the mother was not under treatment. The study was conducted at 17 centers
in Brazil, South Africa, Argentina and the United States over a period of 6
years. The infants included in the study were divided into three groups. One
group received zidovudine alone for 6 weeks. In addition to zidovudine, the
second group also received three doses of the anti-HIV drug nevirapine during
the first 8 days of life. The third group received three drugs - zidovudine for
6 weeks, and nelfinavir and lamivudine for 2 weeks. The infants in all the
groups were not breast-fed.
researchers found that the chances of transmission of HIV during delivery were
reduced in the infants that received two or three drugs as compared to those
who received only zidovudine
. However, the incidence of transmission were
similar between the two and three-drug groups, implying that adding more drugs
to the two-drug regimen may not be beneficial in this case.
A decrease in white blood cell count (neutropenia)
as a side effect of anti-HIV therapy was more significant in the group that was
administered three drugs as compared to the other groups.
researchers thus concluded that a two-drug regimen comprising of zidovudine
plus nevirapine appears to be most effective and safe in preventing
transmission of HIV infection from the mother to the baby during delivery.
1. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV
Infection; Karin Nielsen et al; N Engl J Med 2012; 366:2368-2379