Intrapartum and neonatal zidovudine treatment in reduction of perinatal HIV-1 transmission in Bangkok.
OBJECTIVE
To evaluate the efficacy of zidovudine (ZDV) administered during labor and to the infants in the first 6 weeks of life in reduction of perinatal HIV-1 transmission.


METHODS
Open label clinical trial. SITE: King Chulalongkorn Memorial Hospital, Bangkok, Thailand.


METHODS
One hundred asymptomatic, antiretroviral naive HIV-1 infected pregnant women who had either late or no prenatal care were recruited from the obstetric service of King Chulalongkorn Memorial Hospital, Bangkok, Thailand. They were given ZDV 300 mg orally every 3 hours during the intrapartum period until delivery. ZDV syrup 2 mg/kg orally every 6 hours were given to the infants immediately after birth for 6 weeks. Breast feeding was not allowed. Infant's blood for HIV-1 PCR test was obtained at age 1 day, and 1, 3 and 6 months. HIV-antibody test was determined at age 18 months. Infants with at least one positive HIV-1 PCR test performed at or after 1 month of age or positive HIV-antibody test at age 18 months were classified as HIV-1 infected infants.


RESULTS
There were 100 healthy infants delivered without complication. Fourteen infants were excluded due to; 13 lost to follow-up and 1 drug intolerance. Of the remaining 86 infants who were followed-up, 27 infants (31.4%) did not receive intrapartum ZDV treatment and 9 infants were HIV-1 infected. The perinatal transmission rate was 10.5 per cent, (95% CI 3.9, 17.1).


CONCLUSIONS
The result of this study suggests that intrapartum oral ZDV treatment in asymptomatic HIV-1 infected mothers together with ZDV treatment in the neonates for 6 weeks can reduce the rate of perinatal HIV-1 transmission. This regimen may be an alternative treatment for prevention of HIV-1 infection in infants born to HIV-1 seropositive mothers who have had either late or no prenatal care.
Thaithumyanon
P
P
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Thisyakorn
U
U
Limpongsanurak
S
S
Chaithongwongwatthana
S
S
Punnahitanon
S
S
Ubolyam
S
S
Phanuphak
P
P
Ruxrungtham
K
K
Virutamasen
P
P
D000284:Administration, Oral; D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011322:Primary Prevention / Q000379:methods; D013785:Thailand; D016896:Treatment Outcome; D015215:Zidovudine / Q000008:administration & dosage*
D015215:Zidovudine