Journal Article

Antiretroviral Regimens in Pregnancy and Breast-Feeding in Botswana

Lockman, S, Moyo, S, Souda, S, Lubega, E, Hughes, M.D, Powis, K, Mburu, K, McIntosh, K, Snowden, W, Leidner, J, Essex, M, Ogwu, A, Handelsman, E, Wester, C, van Widenfelt, E, Moko, E, Tuomola, R, Asmelash, A, Kitch, D, Tumbare, E, Martinez-Tristani, M, Akhtar, M, Moffat, C, Thior, I, Shapiro, R.L, Zwerski, S, Jayeoba, O, Sharma, U, Makhema, J, Mazhani, L

2010

Overview

This double-blind, randomized trial in Botswana compared two highly active antiretroviral regimens in HIV-1−infected pregnant women (CD4+ count, ≥200) from pregnancy through 6 months post partum (when breast-feeding ceased). Both regimens were highly effective in suppressing the maternal HIV-1 viral load as well as mother-to-child transmission, with an overall transmission rate of 1.1%. Highly active antiretroviral therapy (HAART) used to prevent in utero and intrapartum mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is among the most successful public health interventions of the HIV era. 1 , 2 However, the use of HAART in mothers to prevent mother-to-child transmission through breast-feeding in areas of the world where replacement feeding is neither safe nor feasible remains an unproven strategy. 1 , 3 We compared different HAART regimens used in pregnancy and during breast-feeding to determine whether the regimens differ with respect to virologic suppression during pregnancy and breast-feeding, pregnancy outcomes, and toxic effects in mothers and infants. . . .

• Publisher: Massachusetts Medical Society
• Subject: Adult / Antiretroviral drugs / Antiretroviral Therapy, Highly Active - adverse effects / Biological and medical sciences / Breast Feeding / CD4 Lymphocyte Count / Female / Follow-Up Studies / General aspects / HIV / HIV Infections - drug therapy / HIV Infections - transmission / HIV Protease Inhibitors - therapeutic use / HIV-1 - genetics / HIV-1 - isolation & purification / Human immunodeficiency virus / Human viral diseases / Humans / Immunodeficiencies / Immunodeficiencies. Immunoglobulinopathies / Immunopathology / Infant / Infant, Newborn / Infectious Disease Transmission, Vertical - prevention & control / Infectious diseases / Male / Medical sciences / Neutropenia - chemically induced / Nevirapine - therapeutic use / Patient Compliance / Pregnancy / Pregnancy Complications, Infectious - drug therapy / Risk Factors / RNA, Viral - blood / Viral diseases / Viral diseases of the lymphoid tissue and the blood. Aids / Viral Load - drug effects / Womens health / Young Adult / Zidovudine - therapeutic use