Reduction of mother-to-child transmission of HIV with short-course zidovudine

Objective: To study the efficacy of short-course oral zidovudine in reducing the riskof mother-to-child HIV transmission. Methods: We enrolled healthy HIV-infected pregnant womenwho attended antenatal clinic In Lampang regional hospital. The zidovudine regimen includedantepartum zidovudine (300 mg tablets twice daily from 34-36 weeks gestation) , intrapartumzidovudine (300 mg tablets every 3 hours from onset of labour until delivery) and zidovudine forthe newborn ( 2 mg per kilogram orally every 6 hours for one week). Mothers were given infantformula and asked not to breastfeed. Infants with atleast one positive HIV RNA , two positiveDIVA PCR at different time , or positive anti-HIV at eighteen months old or more were diagnosedas HIV infected. Results: From January , 1997 through December, 1999 . 166 HIV-infected pregnantwomen were enrolled , 147 gave birth to 148 live-born infants. The median of antepartumtreatment was 37 days and thc median number of doses during labour was three. Trcatment waswell tolerated with no withdrawals because of side effects. Of 137 babies with known HIVinfectionstatus, 9 babies were identified as HIV-infected. The transmission rate was 6.6 %.Co~~clusin:nA shol-t-course oral zidovudine given antepartum , intrapartum , and to the newborn forone week can reduce the rate of mother-to-child HIV transmission to 6.6 %. This safe, low-cost anduncomplicated regimen could prevent many HIV infection during late pregnancy and labour indeveloping countries.