title: Thai Red Cross zidovudine donation program to prevent vertical transmission of HIV: the effect of the modified ACTG 076 regimen.
abstract: OBJECTIVE
  To evaluate the impact of the modified ACTG 076 zidovudine regimen on the risk for vertical HIV transmission.
  
  
  METHODS
  Observational retrospective evaluation of a prospective cohort.
  
  
  METHODS
  Thai Red Cross zidovudine donation program to reduce vertical HIV transmission.
  
  
  METHODS
  HIV-infected Thai women and their offspring.
  
  
  METHODS
  The modified regimen consisted of 500 mg zidovudine daily during pregnancy and 300 mg zidovudine every 3 h during labor, taken orally, and 2 mg/kg zidovudine syrup four times daily for 6 weeks to infants.
  
  
  METHODS
  Only infants with at least 1 HIV DNA polymerase chain reaction (PCR) result at age > or = 4 weeks were included. HIV infection was defined by having at least one positive PCR at age > or = 4 weeks. The transmission rate was calculated. Characteristics of women who did and did not transmit HIV to infants were compared.
  
  
  RESULTS
  A total of 2891 women and their infants participated in the program and 726 infants of 719 women were included in the analysis. Forty-three infants were infected. The overall transmission rate was 6.0% (95% confidence interval, 4.4-8.0). There were no differences in maternal characteristics between transmitters and non-transmitters. The transmission rate in women who started zidovudine before 30 weeks' gestation was not significantly different from that in women who started zidovudine at or after 30 weeks' gestation: 5.7 versus 3.3%, respectively.
  
  
  CONCLUSIONS
  This modified zidovudine regimen is effective in reducing vertical transmission in a country with predominant subtype E infection. A donation program for preventing vertical HIV transmission can be implemented in developing countries, as in Thailand.
authors.affiliation: Thai Red Cross AIDS Research Centre, Thai Red Cross Society, Prathumwan, Bangkok, Thailand. chokechai.r@chula.ac.th
authors.forename: U
authors.initials: U
authors.lastname: Thisyakorn
authors.forename: M
authors.initials: M
authors.lastname: Khongphatthanayothin
authors.forename: S
authors.initials: S
authors.lastname: Sirivichayakul
authors.forename: C
authors.initials: C
authors.lastname: Rongkavilit
authors.forename: W
authors.initials: W
authors.lastname: Poolcharoen
authors.forename: C
authors.initials: C
authors.lastname: Kunanusont
authors.forename: D D
authors.initials: DD
authors.lastname: Bien
authors.forename: P
authors.initials: P
authors.lastname: Phanuphak
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology; D015397:Program Evaluation; D012011:Red Cross / Q000191:economics* / Q000458:organization & administration; D018894:Reverse Transcriptase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D013785:Thailand; D015215:Zidovudine / Q000191:economics / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine