Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
San Francisco Chronicle - Friday, October 23, 1998
Carl T. Hall, Chronicle Science Writer
Officials were troubled by a relatively high incidence of early labor in two of three clinical trials sponsored by the National Institutes of Health. Known as the Pediatric AIDS Clinical Trials Group, the trials are early-stage investigations of different combinations of AIDS drugs.
In a Swiss study, 10 of 30 newborns were delivered before reaching full term, although the protease-inhibitor drugs did not appear to be the culprit. But other studies have found no evidence of danger.
Officials said they need to conduct a full- scale review of all the studies before drawing any conclusions. Meanwhile, the CDC emphasized the clear evidence that the anti-virals work as intended, benefiting both the mother and child.
The CDC recommended no changes in current medical practice and said all women should continue their drug regimens as recommended by their health care providers.
The AIDS drug cocktails typically include a protease inhibitor and two or three other anti- virals such as AZT or 3TC. Little is known yet as to the pregnancy-related side effects of the protease drugs, which have entered into widespread use only during the past two years.
Dr. Karen Beckerman, director of the Perinatal AIDS Center at San Francisco General Hospital, said state-of-the-art therapy during pregnancy has virtually eliminated newborn infections, even in women with advanced cases of full-blown AIDS.
She said there has been no sign of any more preterm births because of the drugs. She noted that many of the HIV-positive women taking the drugs also have other risk factors for early labor, including young age, drug use and multiple sexually transmitted diseases.
"We see lower-than-expected prematurity rates considering the high-risk nature of the population," Beckerman said.
From 1992 to 1996, perinatally acquired AIDS cases dropped 43 percent in the United States, the CDC said. Counseling, testing and drug treatments for pregnant women have saved at least 1,500 babies a year from HIV infection, assuming a 25 percent perinatal transmission rate without the intervention.
"Studies continue to show that perinatal HIV prevention is making a difference, both in terms of lives and resources saved," health officials said.
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