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    HIV Transmission During Breast-Feeding Can Be Reduced

    Risk of HIV transmission may be reduced by triple antiretroviral prophylaxis for mothers

    TUESDAY, Jan. 18 (HealthDay News) -- Triple antiretroviral prophylaxis given during late pregnancy and breast-feeding reduces the risk of HIV transmission to infants, according to a study published online Jan. 14 in The Lancet Infectious Diseases.

    Isabelle de Vincenzi, M.D., Ph.D., from the World Health Organization in Geneva, and colleagues enrolled 824 HIV-positive pregnant women with CD4 cell counts of 200 to 500 cells per µL. The women were randomized either to receive triple antiretroviral prophylaxis therapy in late pregnancy until the cessation of breast-feeding (to a maximum of 6.5 months postpartum), or to receive the standard recommended drug regimen of zidovudine plus single-dose nevirapine.

    The investigators found that the cumulative rate of HIV transmission was lower in the triple antiretroviral treatment group compared with the standard treatment group at six weeks (transmission was 3.3 versus 5 percent) and was significantly lower at 12 months (5.4 versus 9.5 percent transmission). The cumulative rate of HIV transmission and death at 12 months was significantly higher in the standard drug regimen group compared with the triple therapy group. The incidence of adverse effects in mothers and babies was similar between the groups.

    "Early initiation of ART [antiretroviral therapy] is important to achieve undetectable viral load well before delivery; thus, women should be encouraged to plan pregnancies and attend antenatal care sufficiently early to diagnose HIV infection, assess the HIV stage, and initiate ART or antiretroviral prophylaxis as soon as possible," the authors write.

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