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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Twenty-four month efficacy of a maternal short-course zidovudine regimen to prevent mother-to-child transmission of HIV-1 in West Africa
AIDS, Volume 16, No. 4, Year 2002
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Description
Objective: To assess the 24 month efficacy of a maternal short-course zidovudine regimen to prevent mother-to-child transmission (MTCT) of HIV-1 in a breastfeeding population in West Africa. Methods: Data were pooled from two clinical trials: DITRAME-ANRS049a conducted in Abidjan, Côte d'Ivoire and Bobo-Dioulasso, Burkina-Faso and RETRO-CI, conducted in Abidjan. Between September 1995 and February 1998, consenting HIV-1-seropositive women were randomly assigned to receive zidovudine (300 mg) or placebo: one tablet twice daily from 36-38 weeks' gestation until delivery, then in DITRAME only, for 7 more days. Paediatric HIV-1 infection was defined as a positive HIV-1 polymerase chain reaction, or if aged ≥ 15 months, a positive HIV-1 serology. Cumulative risks (CR) of infection were estimated using a competing risk approach with weaning as a competing event. Results: Among 662 live-born children, 641 had at least one HIV-1 test. All but 12 children were breastfed. At 24 months, overall CR of MTCT were 0.225 in the zidovudine and 0.302 in the placebo group, a 26% significant reduction. Among children born to women with CD4 cell counts < 500/ml at enrollment, CR of MTCT were similar, 0.396 in the zidovudine and 0.413 in the placebo group. Among children born to women with CD4 cell counts ≥ 500/ml, CR of MTCT were 0.091 in the zidovudine and 0.220 in the placebo group, a significant 59% reduction. Conclusion: A maternal short-course zidovudine regimen reduces MTCT of HIV-1 at age 24 months, despite prolonged breastfeeding. However, efficacy was observed only among women with CD4 cell counts ≥ 500/ml. New interventions should be considered to prevent MTCT, especially for African women with advanced HIV-1 immunodeficiency. © 2002 Lippincott Williams & Wilkins.
Authors & Co-Authors
Leroy, Valeriane
France, Bordeaux
Université de Bordeaux
Karon, John M.
France, Bordeaux
Université de Bordeaux
Alioum, Ahmadou
France, Bordeaux
Université de Bordeaux
Ekpini, Ehounou René
France, Bordeaux
Université de Bordeaux
Méda, Nicolas Yelbomkan
France, Bordeaux
Université de Bordeaux
Greenberg, Alan E.
France, Bordeaux
Université de Bordeaux
Msellati, Philippe
France, Bordeaux
Université de Bordeaux
Hudgens, Michael G.
France, Bordeaux
Université de Bordeaux
Dabis, Franćois Ç.Ois
France, Bordeaux
Université de Bordeaux
Wiktor, Stefan Zbyszko
France, Bordeaux
Université de Bordeaux
Statistics
Citations: 137
Authors: 10
Affiliations: 1
Identifiers
Doi:
10.1097/00002030-200203080-00016
ISSN:
02699370
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Multi-countries
Ivory Coast
Participants Gender
Female