title: Highly active antiretroviral therapy versus zidovudine for prevention of mother-to-child transmission in a programmatic setting, Botswana.
abstract: Few studies have compared the programmatic effectiveness of the recommended strategies of antenatal highly active antiretroviral therapy (HAART) and zidovudine for prevention of mother-to-child transmission. We prospectively followed infants (93% formula fed) whose mothers who took either HAART (258 infants) or zidovudine (170 infants) during pregnancy in the Botswana national program. Overall, 10 infants (2.5%) acquired HIV--9 infants in the zidovudine group (5.5%, 95% confidence interval: 2.6% to 10.2%) and 1 infant in the HAART group (0.4%, 95% confidence interval: 0.0% to 2.2%). Maternal HAART was associated with decreased prevention of mother-to-child transmission (P = 0.001) and improved HIV-free survival (P = 0.040) compared with zidovudine (with or without single-dose nevirapine) in a programmatic setting.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA 02115, USA. scott_peterson@post.harvard.edu
authors.forename: Scott
authors.initials: S
authors.lastname: Dryden-Peterson
authors.forename: Oluwemimo
authors.initials: O
authors.lastname: Jayeoba
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hughes
authors.forename: Haruna
authors.initials: H
authors.lastname: Jibril
authors.forename: Koona
authors.initials: K
authors.lastname: Keapoletswe
authors.forename: Josephine
authors.initials: J
authors.lastname: Tlale
authors.forename: Taolo A
authors.initials: TA
authors.lastname: Modise
authors.forename: Aida
authors.initials: A
authors.lastname: Asmelash
authors.forename: Sikhulile
authors.initials: S
authors.lastname: Moyo
authors.forename: Erik
authors.initials: E
authors.lastname: van Widenfelt
authors.forename: Joseph
authors.initials: J
authors.lastname: Makhema
authors.forename: Max
authors.initials: M
authors.lastname: Essex
authors.forename: Roger L
authors.initials: RL
authors.lastname: Shapiro
authors.forename: Shahin
authors.initials: S
authors.lastname: Lockman
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001902:Botswana; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011446:Prospective Studies; D015215:Zidovudine / Q000008:administration & dosage*
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine