In Thailand, the prevalence of paediatric HIV-1 infection has increased rapidly through vertical transmission. According to the ACTG 076 trial regimen, zidovudine treatment in HIV-infected pregnancy can reduce vertical transmission. However, this treatment is complex and costly. It is not applicable for developing countries. We conducted a study to evaluate the effect of zidovudine treatment in late pregnancy on HIV-1 in utero transmission. Fifty cases of asymptomatic HIV-1 infected-women were voluntarily enrolled to the study. Zidovudine 250 mg orally twice a day was given to these patients from gestational age 36 weeks until labour. The newborns were evaluated at birth by a neonatologist and peripheral blood was tested for HIV genome by PCR technique within 48 hours of birth. The study revealed that no HIV genome was detected from the peripheral blood of newborns. It is suggested that zidovudine treatment in late pregnancy could reduce HIV-1 in utero transmission.
PIP: In 1995, Ramathibodi Hospital in Bangkok, Thailand, introduced zidovudine (ZDV) treatment in late pregnancy to prevent vertical transmission of HIV infection. The effectiveness of this strategy was assessed in 50 HIV-1-infected pregnant women who were receiving prenatal services at the hospital. The protocol consisted of 250 mg of ZDV orally twice a day from 36 weeks of gestation until the onset of labor. No ZDV was administered in the intrapartum and newborn period. Mothers were urged not to breast feed. The mean duration of ZDV treatment was 24.8 +or- 9.3 days. The most common side effect was nausea and vomiting (16%). Mean birth weight was 3010.25 +or- 301.0 g. No HIV-1 genome was detected in the peripheral blood of any of the 50 infants within 48 hours of birth. This preliminary finding suggests that a short course of ZDV late in pregnancy reduces in utero transmission of HIV infection as effectively as the more complex ZDV regimen. The 50 infants will be followed for up to 18 months to assess the rate of intrapartum and postpartum HIV and the long-term effects of treatment.