United Press International - July 11, 2000
Ed Susman, UPI Science News

The short-course treatment, particularly used in developing countries where extended medication is too costly, reduces the rate of mother-to-child-transmission by more than 40 percent, said Dr. Stefan Wiktor, associate director for science at the Center for Disease Control and Prevention (CDC) global anti-AIDS initiative.

At the XIII International AIDS Conference in Durban, South Africa, Wiktor reported results of trials of the drug AZT in pregnant women in the West African nations of Cote d'Ivoire and Burkino Faso. Working in cooperation with the National French AIDS Research Agency, the researchers treated the HIV-infected mothers of 641 children. Placebo pills were given to 322 children, while the other 319 received AZT, one of the oldest of the medications used to treat AIDS.

After six weeks, Wiktor said, 14 percent of the children on AZT were infected with HIV, the virus that causes AIDS, while 23.6 percent of the children who received the dummy pills were infected. But after two years, about 8 percent of the children who received AZT became infected, most likely through breast milk from their infected mothers. A similar number of the children who were on placebo also became infected, again through breast milk.

"The drugs work," Wiktor said, "but there is a problem in keeping the children free of infection because often there is no acceptable alternative to breast milk for nutrition."

In the U.S., the situation is different, said Subhasree Raghavan, professor of clinical nutrition at Columbia University in New York. First, most women are on long-term antiretroviral therapy, she said, and "we have access to clean water and formula."

In Africa, where uncontaminated water for preparing formula can be difficult to find, mothers have to rely on breast feeding. If the mother is HIV-infected, there is about a 10 percent risk of infecting the child through breast milk, Wiktor said. "That is apparently what occurred in this study."

"The high risk of postnatal transmission, which was similar for the AZT and placebo groups, highlights the importance of identifying interventions to prevent this route of transmission," he said.

In another study, researchers reported that the anti-AIDS drug nevirapine appears to be as effective as AZT in limiting transmission of the virus from the mother to her baby. Wiktor said that study again proves that the drugs are effective in preventing transmission of the virus.

Researchers said that in the developing world more than 200 babies a day are born infected with the virus.
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