Monday, November 29, 1999

Antiretrovirals `prevent HIV transmission through breast milk`

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Giving antiretroviral drugs to HIV-infected mothers or giving HIV-fighting syrups to their babies are both effective in preventing transmission of virus through breastfeeding, a major international study has found."Our study found that both methods are effective in preventing HIV transmission. The antiretroviral regimen for treating the mothers is much more expensive and requires access to medical facilities that aren't widely available in developing countries such as Malawi, The baby regimen, in comparison, is incredibly cheap and much easier to implement."These findings are important because each year about 200,000 infants worldwide become infected with HIV through breastfeeding, and in the developing world infant formula is both prohibitively expensive and associated with increased infant deaths," the study's author Charles van der Horst said.In the study, 2,369 breastfeeding mother-infant pairs in Malawi, were randomly assigned to one of three groups - a maternal antiretroviral therapy (ART) group, a second group in which infants were treated with nevirapine liquid and control group for whom medications were given at the time of delivery only. None of these women had developed AIDS yet and thus did not need treatment for their own health.After their babies were born, women in the maternal antiretroviral group received a single tablet twice a day containing the drugs zidovudine and lamivudine. They also received a dose of nevirapine by mouth once a day for 14 days and then twice daily from 2 to 28 weeks.In the infant prophylaxis group, each infant received a dose of liquid nevirapine by mouth that increased with age, ranging from 1 milliliter a day in the first two weeks to 3 milliliters a day for weeks 19 through 28.Study personnel measured these doses into syringes which were given to the mothers, who then squirted the contents into their infants' mouths.Mothers in the study were asked to wean their babies from breastfeeding by 28 weeks after birth and the study results were calculated after each participant in the treatment arms had completed 28 weeks of treatment.The results showed that infant nevirapine was 74 per cent effective in preventing HIV transmission while maternal antiretroviral therapy was 53 percent effective. In addition, the study found infants had significantly increased HIV-free survival no matter which intervention was used.The findings have been published in the 'New England Journal of Medicine'.

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