Short Course of Zidovudine May Lower Vertical HIV Transmission, Even When Mothers Breastfeed
A short course of zidovudine administered during the last weeks of pregnancy, again during childbirth and for up to a week after delivery can reduce the odds of mother-to-child HIV transmission, even in mother/infant pairs where the child is breastfed, Reuters Health reports. In the study, which was published in the March 8th issue of the journal AIDS, Dr. Valeriane Leroy of INSERM, the French national research institute, and colleagues analyzed results from two studies conducted in Ivory Coast and Burkina Faso. Of the more than 600 children born to women with HIV, those whose mothers received zidovudine, also known as AZT, were 26% less likely to contract HIV, even if their mothers breastfed them. The children were followed for 24 months after birth. However, the same protective benefit was not observed in women with CD4+ T cell counts below 500 -- a sign of advanced disease -- at the time of childbirth. This finding "confirm[s]" that disease stage at the time of childbirth is a "strong determinant" of the overall odds of vertical transmission, according to the authors, who call for further research into the prevention of mother-to-child transmission, especially in women with advanced HIV. Leroy and colleagues suggest starting zidovudine therapy earlier in pregnancy or using the medication in combination with other antiretroviral drugs. The researchers stress that current interventions to reduce vertical HIV transmission in Africa "should not be delayed" or derailed while scientists look for additional ways to prevent transmission (Reuters Health, 3/26).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.