title: Efficacy of antenatal zidovudine in reducing perinatal transmission of human immunodeficiency virus type 1. The New York City Perinatal HIV Transmission Collaborative Study Group.
abstract: New York City women (321) enrolled during 1986-1993 in an observational cohort study were analyzed retrospectively to determine the effectiveness of antenatal zidovudine in reducing perinatal transmission of human immunodeficiency virus type 1 (HIV-1) in women with various CD4+ lymphocyte counts (< 200, 200-499, > 499/microL). When CD4+ lymphocyte level was controlled for, women prescribed zidovudine during pregnancy were less likely to transmit HIV-1 to their infants (adjusted odds ratio, 0.36; 95% confidence interval, 0.14-0.92). There was no conclusive evidence that efficacy of zidovudine depended on CD4+ lymphocyte level, suggesting that women with severe CD4+ cell depression, who are at highest risk of transmitting HIV-1, may also benefit from zidovudine. Antenatal zidovudine treatment alone may substantially lower the risk of perinatal HIV-1 transmission. These data are consistent with the results of AIDS Clinical Trial Group protocol 076 and suggest that a substantial portion of zidovudine's protective effect may occur when used during the antenatal period.
authors.affiliation: Medical and Health Research Association of New York City, Inc., New York, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Matheson
authors.forename: E J
authors.initials: EJ
authors.lastname: Abrams
authors.forename: P A
authors.initials: PA
authors.lastname: Thomas
authors.forename: M A
authors.initials: MA
authors.lastname: Hernán
authors.forename: D M
authors.initials: DM
authors.lastname: Thea
authors.forename: G
authors.initials: G
authors.lastname: Lambert
authors.forename: K
authors.initials: K
authors.lastname: Krasinski
authors.forename: M
authors.initials: M
authors.lastname: Bamji
authors.forename: M F
authors.initials: MF
authors.lastname: Rogers
authors.forename: M
authors.initials: M
authors.lastname: Heagarty
mesh_terms: D016516:CD4-CD8 Ratio; D016022:Case-Control Studies; D004352:Drug Resistance, Microbial; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D018743:Perinatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011295:Prenatal Care; D012189:Retrospective Studies; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D015215:Zidovudine