Thai Health Experts Call for Review of Prevention of Mother-to-Child HIV Transmission Program
Health experts in Thailand are calling for a review of the country's national program to prevent mother-to-child HIV transmission, which follows World Health Organization guidelines, the Bangkok Post reports. According to Manoon Leechanwengwong, president of the Thai AIDS Society, Thailand's current PMTCT program could lead to increased drug resistance among HIV-positive pregnant women.
According to the Post, the WHO guidelines -- which involve administering the antiretroviral zidovudine beginning in the 34th week of pregnancy and the antiretroviral nevirapine during delivery -- could help reduce MTCT to 4%. However, HIV-positive women with CD4+ T cell counts between 500 and 1,500 could develop drug resistance to nevirapine, the Post reports. In contrast, the NIH-recommended regimen to prevent MTCT calls for the administration of a combination antiretroviral in the 14th week of pregnancy through the 34th week. The NIH recommendation also calls for the administration of a combination of the antiretrovirals zidovudine and lamivudine three to seven days after birth to reduce the risk of resistance to nevirapine.
According to Manoon, studies of the NIH regimen have found it could reduce MTCT to 1%. Manoon called for the Thai government to revise and improve the existing PMTCT program to follow NIH recommendations. About 7,000 to 8,000 HIV-positive women become pregnant annually in Thailand, and the number of infants born with HIV could increase to between 1,800 and 2,000 annually without improved MTCT measures, according to Thailand's Ministry of Public Health (Apiradee, Bangkok Post, 9/22).