AEGiS-05CROI: Prevention of perinatal HIV transmission.

5th Conference on Retroviruses and Opportunistic Infections

Chicago, IL - February 1-5, 1998

Prevention of perinatal HIV transmission.

Conf Retroviruses Opportunistic Infect 1998 Feb 1-5; 5th:231 (abstract no. S11)

Mofenson L; National Institute of Child and Human Development, National Institutes of Health, Bethesda, MD.

In 1994, prevention of perinatal transmission became a reality when PACTG 076 demonstrated that a ZDV regimen given during pregnancy, labor and to the newborn reduced transmission by 66%; new data show this ZDV regimen is also effective in infected women with advanced disease, low CD4 count and prior ZDV therapy. How ZDV reduces transmission has not been fully defined-reduction in maternal HIV RNA does not fully account for the observed efficacy, and ZDV lowered transmission regardless of maternal HIV RNA level. It is possible that pre- and post-exposure prophylaxis of the infant is an important mechanism of protection. Whether more potent combination antiretroviral regimens will have enhanced efficacy above that of ZDV alone remains to be evaluated; there is only limited information available regarding the pharmacokinetics and safety of other antiretroviral drugs in pregnant women and neonates. Follow-up of infants and women receiving ZDV in PACTG 076 for 3+ years has not demonstrated any short-term adverse effects of the regimen, but long-term effects are unknown. Incorporation of ZDV prophylaxis into general clinical practice in the U.S. and Europe has been associated with dramatic declines in perinatal HIV transmission, but the complexity and cost of the regimen limit applicability in many developing countries. The success of PACTG 076 has stimulated development of modified antiretroviral and other non-antiretroviral interventions to identify preventive regimens more applicable to the developing world and to further reduce transmission in the U.S. and other industrialized countries.

Keywords: AEGIS, Disease Transmission, Vertical, Zidovudine, HIV, Anti-HIV Agents, HIV Infections, HIV-1, CD4 Lymphocyte Count, Reverse Transcriptase Inhibitors, HIV Protease Inhibitors, Labor, Obstetric, Pregnancy Trimesters, Europe, United States, Human, Female, Pregnancy, Infant, Infant, Newborn, transmission, prevention & control, growth & development, AIDS

1998-02-01
S11

Copyright © 1998 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.