Affiliations: Department of Pediatrics, Faculty of Medicine,
Chulalongkorn University, Bangkok, Thailand | Department of Obstetrics and Gynecology, Faculty of
Medicine, Chulalongkorn University, Bangkok, Thailand
Note: [] Correspondence: Prof. Usa Thisyakorn, Department of Pediatrics,
King Chulalongkorn Memorial Hospital, Chulalongkorn University, King Rama IV
Road, Prathumwan, Bangkok 10330, Thailand. Tel.: +66 2 256 4930; Fax: +66 2 256
4930; E-mail: [email protected]
Abstract: Purpose: To evaluate the safety and efficacy of highly active
antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infected
pregnant women to prevent mother-to-child transmission of HIV. Design of the
study is observational retrospective evaluation of a prospective cohort.
Setting of the study is King Chulalongkorn Memorial Hospital. Participants are
HIV-infected Thai women and their offspring. HIV-positive pregnant women who
received antenatal care were given antepartum and intrapartum zidovudine (ZDV)
plus single dose nevirapine (NVP) or HAART [ZDV + lamivudine (3TC) + NVP] to
prevent HIV transmission to the neonate. All newborns received single dose NVP
plus 6-weeks of ZDV. HAART was given to their parents if indicated. We followed
the infants from February 2003 to June 2006 to determine HIV-status. Calculated
HIV maternal-child transmission rate is the main outcome. Among 157
mother-infant pairs, 44 mothers received ZDV plus single dose NVP and 113
mothers received HAART. There was one HIV-infected child in the first group and
3 in the second group, resulting in 2.3% (95% confidence interval, -2.1 to 6.7)
transmission rate in the first group versus 2.7% (95% confidence interval, -0.3
to 5.6) in the second group (P = 1.000). All non-infected infants had a normal
physical examination at 18 months. Initiation of HAART in HIV-infected pregnant
women had comparable efficacy with ZDV plus single dose NVP to prevent
mother-to-child transmission of HIV. In addition, the program may have
strengthened the role of the family unit and stimulated public awareness
reproductive health planning can help in prevention of HIV/AIDS.
