Postnatal transmission of HIV-1 after a maternal short-course zidovudine peripartum regimen in West Africa.

摘要: Background: To assess the postnatal transmission (PT) risk of HIV-1 after a maternal short-course zidovudine regimen in breastfeeding population. Methods: Data were pooled from two trials: ANRS 049a DITRAME (Abidjan Cote d’Ivoire and Bobo-Dioulasso Burkina-Faso) RETROCI (Abidjan). Consenting seropositive women randomized at 36–38 weeks’ gestation between September 1995 February 1998 to receive oral or placebo: one tablet twice daily until delivery only for 7 more days. A PT case was infection child with negative PCR age > 30 days who later became infected as defined by positive if aged 15 months HIV serology. Cumulative risks (CR) computed using competing approach weaning event. Findings: At 24 CR similar (9.8% n = 254) placebo groups (9.1% 225). In multivariate model factors treatment effect not significant CD4 cell count 500 x 10(6)/l [hazard ratio (HR) 3.14; 95% confidence interval (CI) 1.31–7.49] well an increased plasma viral load entry (HR 2.65 1 log10 increase; CI 1.75–4.00). Interpretation: occurred rate arms therefore reduced long-term overall efficacy this peripartum months. The higher among low emphasizes importance identifying interventions prevent these women. (authors)