Title: Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Cote d'Ivoire: a randomised trial.

POPLINE Document Number: 141403

Author(s):

Wiktor SZ
Ekpini E
Karon JM
Nkengasong J
Maurice C
Severin ST
Roels TH
Kouassi MK
Lackritz EM
Coulibaly IM

Source citation:

Lancet, 1999 Mar 6;353(9155):781-5.

Abstract:

Given the high risk of vertical HIV-1 transmission in Africa, the authors assessed the safety and efficacy of a regimen of short-course perinatal oral zidovudine among HIV-1-seropositive breast-feeding women in Abidjan, Cote d'Ivoire. From April 1996 to February 1998, all consenting, eligible HIV-1-seropositive pregnant women attending a public antenatal clinic in Abidjan were enrolled at 36 weeks' gestation and randomly assigned placebo or zidovudine (300 mg tablets), 1 tablet twice daily until the onset of labor, 1 tablet at the onset of labor, and 1 tablet every 3 hours until delivery. HIV-1 DNA PCR was used to test the infection status of babies at birth, 4 weeks, and 3 months. The study was stopped on February 18, 1998, when efficacy results were available from a study in Bangkok, Thailand, in which the same regimen was used in a non-breast-feeding population. 280 women were enrolled in the study. The median duration of the prenatal drug regimen was 27 days and the median duration of labor was 7.5 hours. Treatment was well tolerated with no withdrawals due to adverse events. All babies were breast-fed. Among babies with known infection status at age 3 months, 30 of 115 (26.1%) in the placebo group and 19 of 115 (16.5%) in the zidovudine group were identified as HIV-1 infected. The estimated risks of HIV-1 transmission in the placebo and zidovudine groups were 21.7% and 12.2% at 4 weeks, and 24.9% and 15.7% at 3 months, respectively. Efficacy was 44% at age 4 weeks and 37% at 3 months. Short-course oral zidovudine therapy was safe, well tolerated, and decreased mother-to-child HIV-1 transmission at age 3 months.

Keywords:

Cote d'Ivoire
Research Report
Pregnant Women
Breastfeeding
HIV Prevention
AIDS Prevention
Mother-to-Child Transmission
Drugs
Prevention and Control
Developing Countries
Africa, Western
Africa, Sub Saharan
Africa
Population Characteristics
Demographic Factors
Population
Infant Nutrition
Nutrition
Health
HIV Infections
Viral Diseases
Diseases
AIDS
Treatment