title: Analysis of the maternal components of the AIDS clinical trial group 076 zidovudine regimen in the prevention of mother-to-infant transmission of human immunodeficiency virus type 1.
abstract: To gain insight into the protective effects of the three components of the zidovudine regimen used in AIDS Clinical Trial Group (ACTG) 076 on mother-to-infant transmission of human immunodeficiency virus (HIV) type 1, 188 zidovudine-treated women and their untreated infants from five HIV-1 obstetric centers were retrospectively studied. The overall rate of mother-to-infant transmission was 12.3% (95% confidence interval [CI], 7.9%-18.0%). When the 38 women with <200 CD4 cells/microL were excluded, the mother-to-infant transmission rate was 8.8% (95% CI, 4.6%-14.8%). This rate compares favorably with the 8.3% transmission in the zidovudine arm of the ACTG 076 study. Apart from low (<200/microL) maternal CD4 cells (P = .016), no factors, including the duration of zidovudine therapy during gestation and intravenous administration of zidovudine during labor, affected the rate of mother-to-infant transmission. These findings suggest that antenatal oral zidovudine may be as effective as antenatal oral plus intravenous zidovudine during labor and the three-component ACTG 076 regimen in decreasing mother-to-infant HIV-1 transmission.
authors.affiliation: University of Rochester, New York, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Frenkel
authors.forename: M K
authors.initials: MK
authors.lastname: Cowles
authors.forename: D E
authors.initials: DE
authors.lastname: Shapiro
authors.forename: A J
authors.initials: AJ
authors.lastname: Melvin
authors.forename: D H
authors.initials: DH
authors.lastname: Watts
authors.forename: C
authors.initials: C
authors.lastname: McLellan
authors.forename: K
authors.initials: K
authors.lastname: Mohan
authors.forename: B
authors.initials: B
authors.lastname: Murante
authors.forename: S
authors.initials: S
authors.lastname: Burchett
authors.forename: Y J
authors.initials: YJ
authors.lastname: Bryson
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: C
authors.initials: C
authors.lastname: Mitchell
authors.forename: D
authors.initials: D
authors.lastname: Landers
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012189:Retrospective Studies; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine