title: Changes in plasma HIV-1-RNA viral load and CD4 cell counts, and lack of zidovudine resistance among pregnant women receiving short-course zidovudine.
abstract: OBJECTIVE
  To describe changes in HIV-1 plasma viral load (VL) and CD4 cell counts and to assess zidovudine resistance associated with a short course of oral zidovudine during late pregnancy.
  
  
  METHODS
  From April 1996 to February 1998 in Abidjan, Côte d'Ivoire, 280 HIV-1-seropositive women were randomly assigned at 36 weeks' gestation to receive zidovudine (300 mg) or placebo twice a day, and then one tablet every 3 h from the onset of labor until delivery. Blood samples obtained every 2 weeks until delivery, then at 2 and 4 weeks, and 3 or 6 months after delivery were tested from selected women based on duration of therapy for plasma VL and CD4 cell counts, and samples from 20 women in the zidovudine group were tested by DNA sequencing for the presence of zidovudine resistance mutations.
  
  
  RESULTS
  In the zidovudine group, the median reduction in plasma VL (log(10) copies/ml) was -0.48 after 2 weeks (P = 0.02 versus placebo), -0.48 after 4 weeks (P = 0.06), -0.80 after 6 weeks (P = 0.29) of treatment, -0.12 at delivery (P = 0.11), +0.21 at 2 weeks (P = 0.83), +0.17 at 4 weeks (P = 0.69), and +0.21 at 3 months (P = 0.56) postpartum. Median CD4 cell counts were higher in the zidovudine than in the placebo group after 2, 4, and 6 weeks of treatment (P < 0.05). No mutations associated with zidovudine resistance were identified in any of the samples tested.
  
  
  CONCLUSIONS
  These findings suggest that a short course of zidovudine has no adverse HIV-1 virological consequences for the mother.
authors.affiliation: Projet RETRO-CI, BP-1712, 01 Abidjan, Côte d'Ivoire.
authors.forename: René-Anatole
authors.initials: RA
authors.lastname: Ekpini
authors.forename: John N
authors.initials: JN
authors.lastname: Nkengasong
authors.forename: Toussaint
authors.initials: T
authors.lastname: Sibailly
authors.forename: Chantal
authors.initials: C
authors.lastname: Maurice
authors.forename: Christiane
authors.initials: C
authors.lastname: Adjé
authors.forename: Ben B
authors.initials: BB
authors.lastname: Monga
authors.forename: Thierry H
authors.initials: TH
authors.lastname: Roels
authors.forename: Alan E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: Stefan Z
authors.initials: SZ
authors.lastname: Wiktor
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D007560:Cote d'Ivoire; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D012367:RNA, Viral / Q000097:blood / Q000187:drug effects*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine