Pregnancy AIDS Treatment Helps

Wednesday, July 12th 2000, 12:00 am
By: News On 6

DURBAN, South Africa (AP) — Treating HIV-infected mothers during pregnancy reduces the number of babies who get AIDS, even if the women risk passing on the virus later through breast-feeding, researchers report.

Several studies have shown that giving AIDS drugs such as AZT during pregnancy can substantially reduce the risk of passing on HIV at birth. However, more than half of all mother-to-child HIV transmission results from breast-feeding, and some have questioned whether the early treatment actually matters in the end.

A new analysis, presented Tuesday at the 13th International AIDS Conference, suggests indeed it does, even though breast- feeding clearly does wipe out much of the advantage of the treatment during pregnancy.

Dr. Stefan Z. Wiktor and colleagues from the U.S. Centers for Disease Control and Prevention analyzed two studies conducted on 641 births in Ivory Coast and Burkina Faso. In both studies, women were treated with AZT during the last month of their pregnancies.

At birth, 14 percent of the babies were infected among mothers getting AZT, compared to 23 percent among those who received dummy pills. The researchers then followed the babies while most of the infected mothers breast-fed.

After two years, 22 percent of the babies whose mothers received AZT were infected, compared with 30 percent of those who got placeboes.

A similar study, to be presented later this week, analyzed how many of the babies in both treatment groups had died of all causes after two years, and not simply how many had AIDS infections. It found no statistically meaningful difference between the two treatment groups.

Wiktor said this is because the survival advantage from AZT was overwhelmed by the large number of deaths from other infant diseases, such as diarrhea.

Wiktor said that while passing HIV through breast milk is a serious dilemma, ``we don't have to solve that problem in order to start these regimens'' to prevent AIDS transmission at birth.

A separate study, conducted in South Africa, confirms an earlier landmark report showing that a simple dose of another AIDS drug called nevirapine is just as effective as more complicated AZT treatment.

The treatment, which costs about $4, involves one dose of nevirapine during labor, one after birth, plus one dose to the newborn. Dr. Daya Moodley of the University of Natal compared this with a combination of the drugs AZT and 3TC.

Eight weeks after birth, the infection rates were virtually identical — 14 percent in the nevirapine babies and 13 percent in the comparison group.

``The message is very simple,'' said Moodley. ``Providing women with a single dose of nevirapine, you can reduce by at least one-third the transmission from mother to child.''

On Friday, Boehringer Ingelheim, which makes nevirapine, said it would offer the drug free to developing countries to help stop mother-to-child spread of HIV.

An estimated 3.8 million children have died of AIDS since the epidemic began.