Tolerance and safety of different concentrations of chlorhexidine for peripartum vaginal and infant washes: HIVNET 025.
BACKGROUND
There is a continuing need to evaluate sustainable interventions for prevention of mother-to-child transmission (MTCT) of HIV type 1. We evaluated different concentrations (0.25%, 1%, and 2%) of chlorhexidine (CHX) for perinatal maternal and infant washes to identify the maximum tolerable concentration of CHX for such an intervention.


METHODS
Women were enrolled during their third trimester at the maternity unit of the Chris Hani Baragwanath Hospital in Soweto, South Africa, and perinatal maternal and infant washes were completed. Subjective maternal symptoms as well as infant examinations were used to assess tolerability of the washes.


RESULTS
The 0.25% concentration of CHX was well tolerated by the mothers (n = 29). Ten of 79 women (13%) with 1% CHX washes complained of mild vaginal area burning or itching, and washes were stopped in 5 (6%). Twenty-three of 75 women (31%) in the 2% CHX wash group had subjective complaints, and the washes were stopped in 12 (16%). There were no clinical indications of toxicity of the CHX washes among infants.


CONCLUSIONS
A 1% solution of CHX appears to be a safe and tolerable concentration of CHX for consideration in an MTCT prevention trial.
Wilson
Craig M
CM
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. cwilson@uab.edu
Gray
Glenda
G
Read
Jennifer S
JS
Mwatha
Anthony
A
Lala
Sanjay
S
Johnson
Saul
S
Violari
Avye
A
Sibiya
Portia Mabali
PM
Fleming
Thomas R
TR
Koonce
Ann
A
Vermund
Sten H
SH
McIntyre
James
J
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission*; D001494:Baths; D002710:Chlorhexidine / Q000097:blood / Q000627:therapeutic use* / Q000633:toxicity; D004202:Disinfectants / Q000627:therapeutic use* / Q000633:toxicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006920:Hygiene; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011263:Pregnancy Trimester, Third; D013997:Time Factors; D014621:Vagina
D004202:Disinfectants; D002710:Chlorhexidine