Affordable drug reduces mother-to-child HIV transmission, study says

VIDEO CNN's Eileen O'Connor reports on the promising results of the Nevirapine drug study. Windows Media 28K 80K  ALSO: Africa welcomes news of cheaper drug to prevent newborn HIV transmission Newsday: New AIDS Medication May Reduce Transmission of Virus from Mother to Child

July 14, 1999
Web posted at: 12:00 p.m. EDT

In this story: Low cost good news for developing countries Finding significant in U.S. as well Drug may protect breast milk from infection RELATED STORIES, SITES

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.

Low cost good news for developing countries

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.

Finding significant in U.S. as well

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.'"

Drug may protect breast milk from infection

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.