Antiviral activity of nucleoside analogues during short-course monotherapy or dual therapy: its role in preventing HIV infection in infants

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Glenda GrayJean-Marie Ledeine

Abstract

This is the first report on the preliminary efficacy of 4 different short-course nucleoside analogue regimens (stavudine [d4T], didanosine [ddI], d4T+ddI, and zidovudine [ZDV]) for the prevention of mother-to-child transmission of HIV-1 (MTCT) in a resource-limited setting. This prospective open-label, randomized 4-arm study (May 1999 to May 2000) conducted in South Africa enrolled 373 women from 34 weeks of gestation; medication was continued through delivery and for 6 weeks to infants. MTCT rates were ascertained at birth, 6, 12, and 24 weeks of age. Mean maternal HIV-1 RNA levels decreased rapidly on treatment in all groups. At week 4, the mean decrease was 1.91 log10 copies/mL (c/mL) in the d4T+ddI group, 1.33 log10 c/mL in the ddI group, 1.12 log10 c/mL in the d4T group, and 0.76 log10 c/mL in the ZDV group. Among the 362 evaluable mother-infant pairs, 11 infants in the d4T group, 10 in the ddI group, 5 in the ZDV group, and 4 in the d4T+ddI group were infected by 24 weeks of age. Eleven infections occurred in utero. Treatment with d4T and ddI was not associated with lactic acidosis or hepatic steatosis. The abbreviated use of nucleoside analogues for the prevention of MTCT appears safe and effective.

References

Aug 5, 1999·The New England Journal of Medicine·M F Rogers, N Shaffer
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Sep 25, 2003·The Pediatric Infectious Disease Journal·Ariane AlimentiJohn C Forbes

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Citations

May 9, 2008·Expert Opinion on Drug Safety·Alain MakinsonEric Delaporte
Oct 5, 2014·The Cochrane Database of Systematic Reviews·Angela B WhiteJennifer S Read
Apr 18, 2009·Current Opinion in HIV and AIDS·Alice Marie Stek
Jul 8, 2011·The Cochrane Database of Systematic Reviews·Nandi SiegfriedTin Tin Sint
Jun 12, 2019·JAMA : the Journal of the American Medical Association·Shelley S SelphRoger Chou

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