title: Prevention of mother-to-child transmission of HIV-1 using highly active antiretroviral therapy in rural Yunnan, China.
abstract: OBJECTIVE
  To demonstrate that the use of highly active antiretroviral therapy (HAART) to interrupt transmission of HIV-1 from mother to baby is effective, safe, and feasible in a remote rural region of China.
  
  
  METHODS
  Between November 2005 and May 2009, we enrolled 279 HIV-1-infected pregnant women to receive HAART to interrupt transmission of HIV-1 to their newborns across 16 counties in Yunnan. All women were started on triple combination therapy and submitted to regular blood draws to monitor CD4 T cells and viral load in their blood plasma. Infants received a single dose of nevirapine at birth and 1 or 4 weeks of zidovudine depending on the length of the mother's regimen. Exclusive formula feeding was recommended, and families were provided with 12-month supply of formula. Mothers and infant pairs were followed for 12-18 months postdelivery.
  
  
  RESULTS
  Of 279 enrolled HIV-infected women, 222 (79.6%) were identified and started treatment by 28 weeks of pregnancy. Viral load was undetectable at time of delivery for 62.4% (136 of 218) at delivery, with a mean 1.76 log viral load reduction between enrollment and delivery. Two of 193 babies (1.0%) who have already been tested became infected with HIV-1. Seven of 223 babies have died. By Kaplan-Meier analysis, cumulative one-year survival was 96.3%.
  
  
  CONCLUSIONS
  The project demonstrated that HAART for all infected pregnant women is effective with a vertical transmission rate of approximately 1%. Thus, this project provides a model for China to scale up its efforts to prevent mother-to-child transmission of HIV-1.
authors.affiliation: Yunnan AIDS Care Center, Kunming, China. ynzzq@263.net
authors.forename: Zengquan
authors.initials: Z
authors.lastname: Zhou
authors.forename: Kathrine
authors.initials: K
authors.lastname: Meyers
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Qingling
authors.initials: Q
authors.lastname: Chen
authors.forename: Haoyu
authors.initials: H
authors.lastname: Qian
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Lao
authors.forename: Elvin
authors.initials: E
authors.lastname: Geng
authors.forename: Yishan
authors.initials: Y
authors.lastname: Fan
authors.forename: Shaomin
authors.initials: S
authors.lastname: Yang
authors.forename: Michael
authors.initials: M
authors.lastname: Chiu
authors.forename: David D
authors.initials: DD
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D012424:Rural Population; D013997:Time Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents