Inexpensive drug works well in infant HIV study

Newborns need 1 dose vs. 6 weeks of AZT

July 14, 2002|By NEW YORK TIMES NEWS SERVICE

BARCELONA, Spain - A new study has shown that a simple and inexpensive drug given just once after birth can protect many infants from infection with the virus that causes AIDS, South African researchers reported at the 14th International AIDS Conference, which ended here Friday.

In the study, babies who were given a single dose of the AIDS drug nevirapine within 24 hours after birth were no more likely to become infected with HIV than those given another drug, AZT, for the first six weeks of life.

One dose of nevirapine costs 75 cents. A six-week course of AZT costs about $40, said Dr. Glenda Gray, head of the team that reported the study.

Gray said her team was using the new regimen at the Chris Hani Baragwanath Hospital in Soweto.

The findings, she said in an interview, "provide policy-makers an alternative" for pregnant women. But, she added, the findings needed to be confirmed in additional studies before the regimen was more widely adopted.

Giving nevirapine to a woman during labor and then to her newborn is considered the most feasible way to prevent transmission of HIV from an infected mother to her newborn in developing countries, Gray said.

She said her team undertook the study because she and other pediatricians did not know how effective preventive therapy would be if they gave nevirapine only to a newborn and not to the mother.

So Gray, Dr. James McIntyre and their team devised a study to compare nevirapine with AZT among newborns whose moth- ers chose not to take anti-HIV therapy during pregnancy or labor.

From October 2000 through February, the researchers tested the mothers of the 781 infants in the study for evidence of HIV during labor or delivery. Infected mothers who chose preventive therapy were not included in the study.

For scientific comparison, infected mothers who rejected therapy for themselves agreed to let the statistical equivalent of a coin toss determine which therapy their babies would receive. Half were given the single dose of nevirapine, the other half AZT for six weeks.

The researchers found that of the babies who tested negative for HIV at birth, 7.3 percent of those receiving nevirapine became infected compared with 10.7 percent of those receiving AZT. Statistical analysis showed the difference could be a result of chance.

But, as Gray said, "for 75 cents you get as much effectiveness as $40."

The study found that the single dose of nevirapine protected a breast-fed baby from infection for six weeks. Earlier studies have suggested that most infections transmitted through breast milk occur in the first six weeks of life.

The risk of infection increased if the mother breast-fed and the infant received AZT. Gray speculated that one reason for the difference was that AZT irritated an infant's stomach, allowing easier entry of HIV.

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