Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type 1 with Zidovudine Treatment

TLDR

Maternal‑infant transmission is the primary route by which young children acquire HIV‑1. The study aimed to evaluate the efficacy and safety of zidovudine in reducing maternal‑infant HIV transmission through a randomized, double‑blind, placebo‑controlled trial. HIV‑positive pregnant women with CD4 counts >200 cells/µL between 14–34 weeks gestation who had not received antiretroviral therapy were enrolled and given a zidovudine regimen of antepartum oral dosing, intrapartum intravenous dosing, and six‑week oral dosing to newborns, with infants classified as infected if at least one peripheral‑blood mononuclear cell culture was positive.

Abstract

Maternal-infant transmission is the primary means by which young children become infected with human immunodeficiency virus type 1 (HIV). We conducted a randomized, double-blind, placebo-controlled trial of the efficacy and safety of zidovudine in reducing the risk of maternal-infant HIV transmission. HIV-infected pregnant women (14 to 34 weeks' gestation) with CD4+ T-lymphocyte counts above 200 cells per cubic millimeter who had not received antiretroviral therapy during the current pregnancy were enrolled. The zidovudine regimen included antepartum zidovudine (100 mg orally five times daily), intrapartum zidovudine (2 mg per kilogram of body weight given intravenously over a one-hour period, then 1 mg per kilogram per hour until delivery), and zidovudine for the newborn (2 mg per kilogram orally every six hours for six weeks). Infants with at least one positive HIV culture of peripheral-blood mononuclear cells were classified as HIV-infected.