Mother-to-Infant HIV Transmission Study

Mother-to-Infant HIV Transmission Study

Being Alive; March 1994

The National Institutes of Health (NIH) stopped a clinical trial (ACTG 076) investigating whether giving AZT to pregnant HIV-infected women during pregnancy and labor and to newborns for six weeks after birth would reduce the proportion of babies born with HIV.

Study Design

Participants were HIV+ pregnant women who had received no antiretroviral treatment during the current pregnancy and had no clear clinical indication to do so and had a CD4 less than 200. They were randomized to receive AZT or placebo beginning between 14 and 34 weeks of pregnancy. The AZT regimen consisted of 500 mg/day until the start of labor, then IV AZT during labor, then a syrup form given to the newborn for six weeks. The infants were evaluated at 12, 24 and 78 weeks after birth to see if HIV could be cultured from their blood.

Results

Of the 364 babies with sufficient data to be evaluated, 13 (8.3%) in the AZT group vs. 40 (25.5%) in the placebo arm were HIV infected. Thus, the use of AZT in this particular group reduced the risk of mother-to-infant transmission by 67.5%. Side effects were equal in both groups, except that the babies in the AZT group had a higher incidence of a mild anemia at birth, which disappeared gradually without requiring transfusion. The rate of congenital malformations was also equal and the same as the normal rate in the population, and there were no adverse effects on the mothers in either group.

Conclusions

The typical risk of mother-to-infant HIV transmission in the US is from 20-25%. The potential reduction to about 8% is obviously exciting news.

We must be careful to remember that the results are directly applicable only to women similar to those in this trial. In particular, the long term risks of the AZT use, including in the HIV negative infants, remains to be assessed. It is important that everyone be followed for a long time.There is also danger that these results will be taken as evidence for mandatory HIV antibody testing of all pregnant women, and even the mandatory use of AZT. We must be vigilant to fight any such proposals.

940301
BA940314

AEGiS is made possible through unrestricted grants from Roxane Laboratories, the National Library of Medicine, and donations from users like you. Always watch for outdated information. Always watch for outdated information. This article first appeared in 1994. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1994 - Beings Alive. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. Subscription lists are kept confidential. Being Alive, 621 N. San Vicente Blvd., West Hollywood, CA 90069, Tel - 310.289.2551; FAX - 310.289.9866; Email: BeiAlive@aol.com http://www.beingalivela.org/

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1994. AEGIS.