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Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission
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Journal Article
Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission
2008
Overview
The prevention of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) during breast-feeding is a unique opportunity to curtail the AIDS epidemic. In this trial in Malawi, 3016 infants without HIV-1 infection who were born to infected mothers were randomly assigned to receive a single dose of nevirapine plus 1 week of zidovudine (control regimen) or the control regimen plus extended daily prophylaxis with nevirapine or with nevirapine plus zidovudine until the age of 14 weeks. Extended prophylaxis significantly decreased the rate of HIV-1 transmission (10.6%, 5.2%, and 6.4%, respectively) at 9 months.
In this trial in Malawi, infants without HIV-1 infection who were born to infected mothers were randomly assigned to receive a single dose of nevirapine plus 1 week of zidovudine (control regimen) or the control regimen plus extended daily prophylaxis until the age of 14 weeks. Extended prophylaxis significantly decreased the rate of HIV-1 transmission at 9 months.
In sub-Saharan Africa, where breast-feeding is critical for infant survival, postnatal transmission of human immunodeficiency virus type 1 (HIV-1) occurs in up to 16% of untreated infants when breast-feeding continues into the second year of life.
1
Although effective interventions have been identified to reduce in utero and intrapartum transmission of HIV-1 in resource-limited countries,
2
breast-feeding attenuates the efficacy of such methods.
3
,
4
Thus, a major concern in developing countries is HIV-1 transmission through breast milk.
5
To optimize the survival of infants who are born to mothers with HIV-1 infection, interventions that allow safe breast-feeding during the first 6 months of . . .
Publisher
Massachusetts Medical Society
Subject
Anti-HIV Agents - administration & dosage
/ Anti-HIV Agents - adverse effects
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Biological and medical sciences
/ Drug Administration Schedule
/ Female
/ HIV
/ HIV Infections - epidemiology
/ HIV Infections - prevention & control
/ HIV Infections - transmission
/ HIV-1
/ Human immunodeficiency virus
/ Humans
/ Infant
/ Infectious Disease Transmission, Vertical - prevention & control
/ LDCs
/ Male
/ Neutropenia - chemically induced
/ Nevirapine - administration & dosage
/ Nevirapine - adverse effects
/ Pharmacology. Drug treatments
/ Virology
