Strategy for preventing vertical transmisssion of HIV : Bombay experience.
OBJECTIVE
To evaluate the efficacy of an interventional regime to reduce the perinatal mode of transmission of human immunodeficiency virus (HIV).


METHODS
Prospective.


METHODS
Perinatal HIV clinic at a university affiliated maternity hospital.


METHODS
After adequate counseling, consenting HIV positive women were offered perinatal intervention: (i) administration of 400 mg of zidovudine (AZT) per day for the last 6 weeks of the antenatal period; (ii) delivery by elective Caesarian section before rupture of membrances; (iii) oral AZT powder in the dose of 8 mg per kilogram daily to the infant for the first 6 weeks of life; and (iv) avoidance of breast milk. The infants were scheduled for regular follow-up for at least 18 months. A definitive diagnosis of infectivity in the infant was ascertained by two positive enzyme-linked immunosorbent assays (ELISA) at the age of 9 months and between 15 to 18 months.


RESULTS
Of the 107 mother-infant pairs enrolled, 22 infants were lost to follow-up, 15 were under 18 months of age at the time of this analysis and 2 infants died without a diagnosis. Of the remaining 68 infants followed up, 4 tested HIV positive at 18 months. Of the 229 women-infant pairs who did not receive perinatal intervention, 55 infants followed up to 15-18 months were found to be infected.


CONCLUSIONS
This interventional strategy significantly reduced the mother to child transmission of HIV. However, the results need to be substantiated by larger studies.
Merchant
R H
RH
Nowrosjee Wadia Maternity Hospital, Acharya Dhonde Marg, Parel, Mumbai 400 012, India. deandoc2000@yahoo.co.uk
Damania
K
K
Gilada
I S
IS
Bhagwat
R V
RV
Karkare
J S
JS
Oswal
J S
JS
Merchant
S R
SR
Changedia
S
S
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D007194:India; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011446:Prospective Studies; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine