PI Perspective 21: AZT During Pregnancy

Important note: Information in this article was accurate in March, 1997. The state of the art may have changed since the publication date.

PI Perspective 21: AZT During Pregnancy

Project Inform - March, 1997

The NIH recently held an independent panel to assess data from two studies of AZT toxicity to mouse fetuses and whether this new data had implications for AZT use in pregnant women. AZT is recommended for use in late stage pregnancy and in newborns because an earlier study showed it reduced the risk of mother-to-child transmission by 2/3. The panel concluded the benefits of AZT in preventing perinatal transmission outweigh any risks of AZT leading to cancer in the child.

A new National Cancer Institute (NCI) study showed that very high daily doses of AZT given in the last trimester, increased in the number of liver, lung and reproductive tumors several-fold over the life of mouse offspring. The AZT dose was very high, the maximum the fetus could survive. A study by AZT's manufacturer, showed other results. This study used clinically relevant doses (1/12 to 1/50 those in the NCI study) and showed no greater rsik of tumors except in one group of offspring receiving AZT over their entire lifetime. Researchers acknowledged that it is unknown if this mouse model can predict carcinogenic effects in humans. There are no reports of such tumors in children.

The panel concluded that the benefits of AZT clearly outweigh its carcinogenic risk. The panel stressed the need to counsel HIV-infected pregnant women on the benefits and risks of AZT and recommended follow-up of children exposed to AZT in utero to assess the long-term effects of therapy used during pregnancy.

While the studies provide no basis for alarm about recommendations for AZT use to prevent perinatal transmission, they stress the need for safer, more effective treatment for pregnant women. Project Inform has long noted that if AZT can produce a 2/3 drop in perinatal transmission, then new therapies should be more effective, perhaps stopping transmission altogether. Studies using such combinations should be a high priority for AIDS research.

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Always watch for outdated information. This article first appeared in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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The original of this article can be found at http://www.projinf.org/pub/21/AZTPregnancy.html

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1997. AEGiS.