Affordable drug reduces mother-to-child HIV transmission, study says
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CNN's Eileen O'Connor reports on the promising results of the Nevirapine drug study.
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July 14, 1999
Web posted at: 12:00 p.m. EDT
WASHINGTON (CNN) -- An AIDS drug already available could prevent nearly 1,000 babies a day from contracting HIV at a cost developing countries can afford, according to a joint Uganda-U.S. study released Wednesday.
The study conducted in Uganda, which has one of the highest rates of HIV infection in the world, found two doses of the drug nevirapine can dramatically reduce the transmission of HIV from mother to child.
Over 600 HIV-infected mothers in Uganda participated in the study. Some 300 women were given a dose of nevirapine during labor, and their newborns were given another dose within three days of birth. The others in the trial were given the more traditional treatment of a short course of AZT.
Of more than 300 who took nevirapine, only 40 babies were infected with the HIV virus, while 77 of the newborns with the AZT treatment were infected.
COST COMPARISON:
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Extensive AZT treatment: $1000
Short course AZT treatment: $100
Nevirapine treatment: $4
Note: All costs are approximate.
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Researchers say the other good news is that nevirapine costs only $4 per treatment.
"This is going to open up an entire new avenue now of approach towards
prevention of transmission of HIV from an infected pregnant woman to her infant
in countries that previously could not afford it," said Dr. Anthony Fauci, a leading AIDS researcher of the National Institutes of Health who was involved in the study.
Without any HIV medications, a pregnant woman has a 25 percent to
35 percent risk of transmitting HIV to her child during delivery. With
nevirapine, that risk drops to a 13 percent chance of transmitting the virus, according to researchers.
Currently 1,800 babies worldwide are born infected with the HIV virus every day. According to Fauci, nevirapine could save nearly 1,000 of them each day.
Currently in a developed country like the United States, doctors give HIV-infected pregnant women
the drug AZT throughout the second and third trimesters of a pregnancy and during delivery, and then to the infant for several weeks after birth.
While this extended AZT treatment can reduce transmission of HIV, it costs close to $1,000 and is not practical or affordable for many.
Most recently it was shown that a shorter course of AZT could also
decrease transmission, but even the shorter course costs about $100, which is still very high for a poor country like Uganda.
DOCTOR Q&A: |
Read what doctors say about accurate HIV testing or ask your own questions.
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In the United States, where so many of these cases involve mothers who receive no prenatal care, the study is also seen as significant. It means doctors will be able to prevent transmission of the virus even if an HIV-infected woman appears at a hospital or doctor's office only at the onset of labor.
"It might come in handy ... when people
come into a clinic or emergency room not having any prenatal care whatsoever,
and they come in just about to go into labor," Fauci said.
"You won't be in a frustrating situation of saying, 'My goodness, you should
have come in 25 weeks ago or 30 weeks ago when you first knew you were
pregnant.'"
Nevirapine works well with such a low dosage because it stays in the body
a long time. Thus it may help cut transmission through breast milk, the study suggests, since all mothers in the study were breast-feeding.
Currently a third of HIV infections in infants come from breast-feeding.
Fauci says more studies on that subject are under consideration.
The Uganda-U.S. study was funded in part by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
Nevirapine is marketed under the name Viramune by Boehringer Ingelheim Corp. of Germany.
Medical Correspondent Eileen O'Connor contributed to this report.
SPECIAL SECTION:
Health - AIDS
RELATED STORIES:
Women and AIDS: The forgotten epidemic July 9, 1999
Ethics Matters -- Risky Business: Helping the HIV-Infected Have Babies July 1999
Cash-strapped S. African government cuts AIDS drug programs May 6, 1999
FDA approves new drug to fight HIV April 16, 1999
Panel: HIV testing should be routine for pregnant women October 14, 1998
South African government urges nation to fight AIDS pandemic October 9, 1998
AIDS conference sounds alarm over rich-poor divide July 4, 1998
Study: AZT, Caesareans reduce HIV spread to infants June 27, 1998
RELATED SITES:
Boehringer Ingelheim Corp.
National Institutes of Health
National Institute of Allergy and Infectious Diseases
International AIDS Vaccine Initiative Home Page (IAVI)
HIV and AIDS
AZT and AIDS, The Relationship Between HIV and AIDS
Project Inform Perspective 21: AZT During Pregnancy
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