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J Acquir Immune Defic Syndr. 2010 Feb;53 Suppl 1:S15-22. doi: 10.1097/QAI.0b013e3181c7d47b.

Prevention of mother-to-child transmission of HIV-1 using highly active antiretroviral therapy in rural Yunnan, China.

Author information

1
Yunnan AIDS Care Center, Kunming, China. ynzzq@263.net

Abstract

OBJECTIVE:

To demonstrate that the use of highly active antiretroviral therapy (HAART) to interrupt transmission of HIV-1 from mother to baby is effective, safe, and feasible in a remote rural region of China.

METHODS:

Between November 2005 and May 2009, we enrolled 279 HIV-1-infected pregnant women to receive HAART to interrupt transmission of HIV-1 to their newborns across 16 counties in Yunnan. All women were started on triple combination therapy and submitted to regular blood draws to monitor CD4 T cells and viral load in their blood plasma. Infants received a single dose of nevirapine at birth and 1 or 4 weeks of zidovudine depending on the length of the mother's regimen. Exclusive formula feeding was recommended, and families were provided with 12-month supply of formula. Mothers and infant pairs were followed for 12-18 months postdelivery.

RESULTS:

Of 279 enrolled HIV-infected women, 222 (79.6%) were identified and started treatment by 28 weeks of pregnancy. Viral load was undetectable at time of delivery for 62.4% (136 of 218) at delivery, with a mean 1.76 log viral load reduction between enrollment and delivery. Two of 193 babies (1.0%) who have already been tested became infected with HIV-1. Seven of 223 babies have died. By Kaplan-Meier analysis, cumulative one-year survival was 96.3%.

CONCLUSIONS:

The project demonstrated that HAART for all infected pregnant women is effective with a vertical transmission rate of approximately 1%. Thus, this project provides a model for China to scale up its efforts to prevent mother-to-child transmission of HIV-1.

PMID:
20104104
DOI:
10.1097/QAI.0b013e3181c7d47b
[Indexed for MEDLINE]
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