Document 0837
 DOCN  M95A0837
 TI    Prevention of maternal HIV transmission. Practical guidelines.
 DT    9510
 AU    Rouzioux C; Hopital Necker-Enfants Malades, Paris, France.
 SO    Drugs. 1995;49 Suppl 1:17-24; discussion 38-40. Unique Identifier :
       AIDSLINE MED/95339779
 AB    The recently published Protocol 076 study (ACTG 076/ANRS 024) showed
       that zidovudine significantly decreased the relative risk of maternal
       HIV transmission by 71.5% compared with placebo. Oral zidovudine 100 mg
       five times daily until the onset of labour, followed by intravenous
       zidovudine 2 mg/kg over 1 hour then 1 mg/kg.h until delivery, or an
       identical placebo regimen were administered to HIV-infected pregnant
       women (14 to 34 weeks' gestation) with CD4+ counts > 200
       cells/microliters. 400 babies born to these women received zidovudine
       syrup 2 mg/kg or placebo administered 6-hourly for 6 weeks. The
       zidovudine regimens were well tolerated by both mothers and infants.
       Further studies should aim to determine the mechanism by which
       zidovudine reduces the risk of maternal HIV transmission, the timing of
       HIV transmission, the efficacy of zidovudine in women not meeting the
       entry criteria for Protocol 076 and the long term effects of zidovudine
       during pregnancy on both mother and infant, and should examine the
       possibility of developing a simplified zidovudine regimen. Following
       recent guidelines from the US and French public health services, the
       full Protocol 076 regimen should be given to all women fulfilling that
       study's entry criteria. This regimen should also be considered in women
       with more severe disease or in later stages of gestation. Clinical
       efficacy of zidovudine should be monitored closely in women and infants,
       who should also be followed up for long term adverse effects. Unblinded
       screening for HIV in pregnant women in the USA is facing extreme
       opposition; nevertheless, guidelines on HIV counselling and HIV testing
       of pregnant women are currently being developed there in light of the
       Protocol 076 findings.
 DE    Disease Transmission, Vertical/*PREVENTION & CONTROL  Drug
       Administration Schedule  Female  France  Health Policy  Human  HIV
       Infections/DIAGNOSIS/PREVENTION & CONTROL/*TRANSMISSION  Infant, Newborn
       Practice Guidelines  Pregnancy  Randomized Controlled Trials  United
       States  Zidovudine/*ADMINISTRATION & DOSAGE  JOURNAL ARTICLE  REVIEW
       REVIEW, TUTORIAL

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