Antiretroviral Regimens in Pregnancy and Breast-Feeding in Botswana
Roger L. Shapiro,Anthony Ogwu,Douglas Kitch,Shahin Lockman,Claire Moffat,Joseph Makhema,Sikhulile Moyo,Ibou Thior,Kenneth McIntosh,E. van Widenfelt,Jean Leidner,Kathleen M. Powis,Aida Asmelash,Esther Tumbare,S. Zwerski,U. Sharma,E. Handelsman,K. Mburu,Oluwemimo Jayeoba,E. Moko,Sajini Souda,E. Lubega,M. Akhtar,Carolyn Wester,R. Tuomola,W. Snowden,M. Martinez-Tristani,Loeto Mazhani,Myron Essex,Abstr Act +29 more
TLDR
All regimens of HAART from pregnancy through 6 months post partum resulted in high rates of virologic suppression, with an overall rate of mother-to-child transmission of 1.1%.Abstract:
Background The most effective highly active antiretroviral therapy (HAART) to prevent mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) in pregnancy and its efficacy during breast-feeding are unknown. Methods We randomly assigned 560 HIV-1−infected pregnant women (CD4+ count, ≥200 cells per cubic millimeter) to receive coformulated abacavir, zidovudine, and lamivudine (the nucleoside reverse-transcriptase inhibitor [NRTI] group) or lopinavir−ritonavir plus zidovudine−lamivudine (the protease-inhibitor group) from 26 to 34 weeks' gestation through planned weaning by 6 months post partum. A total of 170 women with CD4+ counts of less than 200 cells per cubic millimeter received nevirapine plus zidovudine−lamivudine (the observational group). Infants received single-dose nevirapine and 4 weeks of zidovudine. Results The rate of virologic suppression to less than 400 copies per milliliter was high and did not differ significantly among the three groups at delivery (96% in the NRTI gr...read more
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