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Pregnancy Complications

HIV/AIDS in Pregnancy

Drug Cuts Mother-to-Child
HIV Transmission by Half

An ongoing joint study by the United States and Uganda has uncovered an inexpensive, safe, yet very effective method for preventing the spread of the human immunodeficiency virus (HIV) from mother to fetus.

A single dose of the antiretroviral medication nevirapine was given to pregnant women infected with HIV while they were in labor. The babies received another dose within three days after their birth. This combination was found to cut the rate of HIV transmission from mother to child by 50 percent.

As is common practice, the new regimen was tested against whatever is considered the "standard." In this case, the standard treatment for pregnant women with HIV is a course of treatment with AZT. However, AZT therapy, even if for just a short while, is very expensive, and there are many economically struggling countries that simply can't afford to provide AZT to all pregnant women. Many of these women don't receive any prenatal care at all, and it's estimated that every day, over 1,500 infants are born HIV-positive in developing nations.

Though the final results have not been calculated, the positive response was so overwhelming that the interim results have been released. These results are based on information from 618 women, 310 took nevirapine and 308 received AZT. The children born to the AZT group had a 25 percent infection rate at 14 and 16 weeks old. However, the nevirapine children had only a 13 percent infection rate, 47 percent less than the AZT group.

The next priority is to follow these mothers and children to ensure that the drug has no long-term adverse effects. Also, breastfeeding remains a major source of HIV transmission, which no drug has yet overcome.

Women in most industrialized countries already take AZT or a combination of medications to prevent the transmission of HIV to their babies. However, there is a study going on in Europe and the United States to see if adding nevirapine to this regimen will have additional benefits. In addition, since the nevirapine needs to only be used one time during labor, it provides a last minute preventative measure.

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