Two-drug Regimen Effective in Reducing Mother-to-Child HIV Transmission During Delivery

A recent study concluded that a two-drug regimen comprising of zidovudine for 6 weeks along with three doses of nevirapine is safe and effective in reducing transmission of HIV from mother to the infant during delivery. The mothers in these cases did not receive prior HIV treatment.

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.

The 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.

The 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.

Reference:

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1. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection; Karin Nielsen et al; N Engl J Med 2012; 366:2368-2379

Source-Medindia