title: Effect of immediate neonatal zidovudine on prevention of vertical transmission of human immunodeficiency virus type 1.
abstract: OBJECTIVE
  To describe the effects of various short zidovudine (ZDV) prophylactic regimens on vertical transmission of human immunodeficiency virus type 1 (HIV-I) infection, especially the effect of immediate neonatal ZDV prophylaxis.
  
  
  METHODS
  The study included children of HIV-1-infected mothers who were born at a teaching hospital in Bangkok. The ZDV prophylaxis regimens varied by time periods that included: (1) no ZDV (1991-1996); (2) antenatal oral ZDV, 250 mg given twice a day starting at 34 to 36 weeks gestation and continued until labor (1995-1998); (3) antenatal oral ZDV plus immediate neonatal oral ZDV, 6 mg/0.6 mL/dose started within the first 2 hours after birth and continued at 6-hour intervals for 4 to 6 weeks (1997-1998); and (4) intrapartum intravenous ZDV given in addition to regimen 3 (1998-1999). Neonatal ZDV was administered within 2 hours after birth in 95% of the neonates.
  
  
  RESULTS
  In a cohort of 136 children born at least 9 months before the analysis date, the HIV-1 vertical infection rates were: (1) no ZDV, 11 of 48 (22.9%, 95% confidence interval [CI] = 12.0-37.3); (2) late antenatal ZDV, 10 of 47 (21.3%, 95% CI = 10.7-35.7); (3) late antenatal ZDV plus immediate neonatal ZDV, 0 of 28 (0%, 95% CI = 0-12.3); (4) late antenatal, intrapartum intravenous ZDV, plus immediate neonatal ZDV, 0 of 13 (0%, 95% CI = 0-24.7). An estimated 0% (95% CI = 0-8.6) of the infants who received immediate neonatal ZDV with or without intrapartum ZDV were infected, as compared with 22.1% (95% CI = 14.2-31.8 ) of those who received no ZDV or only late antenatal ZDV (P < 0.001).
  
  
  CONCLUSIONS
  The results of this study suggests high protective effect of immediate administration of neonatal ZDV. Perinatal components of antiretroviral prophylaxis provided the best results for protecting against vertical HIV-1 transmission.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rassr@mahidol.ac.th
authors.forename: S
authors.initials: S
authors.lastname: Sirinavin S
authors.forename: W
authors.initials: W
authors.lastname: Phaupradit
authors.forename: S
authors.initials: S
authors.lastname: Taneepanichskul
authors.forename: K
authors.initials: K
authors.lastname: Atamasirikul
authors.forename: P
authors.initials: P
authors.lastname: Hetrakul
authors.forename: A
authors.initials: A
authors.lastname: Thakkinstian
authors.forename: P
authors.initials: P
authors.lastname: Panburana
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine