title: Short-course antenatal zidovudine reduces both cervicovaginal human immunodeficiency virus type 1 RNA levels and risk of perinatal transmission. Bangkok Collaborative Perinatal HIV Transmission Study Group.
abstract: Human immunodeficiency virus (HIV) levels in cervicovaginal lavage (CVL) and plasma samples were evaluated in relation to perinatal transmission in a randomized placebo-controlled trial of brief antenatal zidovudine treatment. Samples were collected at 38 weeks' gestation from 310 women and more frequently from a subset of 74 women. At 38 weeks, after a 2-week treatment period, CVL HIV-1 was quantifiable in 23% and 52% of samples in the zidovudine and placebo groups, respectively (P<.001). The perinatal transmission rate was 28.7% among women with quantifiable CVL HIV-1 and high plasma virus levels (>10,000 copies/mL) and 1% among women without quantifiable CVL HIV-1 and with low plasma virus levels (P<.001). A 1-log increase in plasma HIV-1 increased the transmission odds 1.8 and 6.1 times (95% confidence interval, 0.9-3.5 vs. 2.4-15.4) for women with and without quantifiable CVL HIV-1, respectively (P=.03). CVL HIV-1 is an independent risk factor for perinatal HIV-1 transmission.
authors.affiliation: Faculty of Medicine, Siriraj Hospital, Mahidol University, and HIV/AIDS Collaboration, Nonthaburi, Thailand. rfc3@cdc.gov
authors.forename: R
authors.initials: R
authors.lastname: Chuachoowong
authors.forename: N
authors.initials: N
authors.lastname: Shaffer
authors.forename: W
authors.initials: W
authors.lastname: Siriwasin
authors.forename: P
authors.initials: P
authors.lastname: Chaisilwattana
authors.forename: N L
authors.initials: NL
authors.lastname: Young
authors.forename: P A
authors.initials: PA
authors.lastname: Mock
authors.forename: S
authors.initials: S
authors.lastname: Chearskul
authors.forename: N
authors.initials: N
authors.lastname: Waranawat
authors.forename: T
authors.initials: T
authors.lastname: Chaowanachan
authors.forename: J
authors.initials: J
authors.lastname: Karon
authors.forename: R J
authors.initials: RJ
authors.lastname: Simonds
authors.forename: T D
authors.initials: TD
authors.lastname: Mastro
mesh_terms: D002584:Cervix Uteri / Q000821:virology; D005260:Female; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000517:prevention & control*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D049590:Postpartum Period; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012367:RNA, Viral / Q000302:isolation & purification; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D014621:Vagina / Q000821:virology; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D012367:RNA, Viral; D015215:Zidovudine