E-drug: Antibiotics may reduce vertical HIV transmission rates
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I got this just today. Does anyone have anything to say about this?
Antibiotics may reduce vertical HIV transmission rates
WESTPORT, Dec 11 (Reuters Health) - Administration of antibiotics to
HIV-positive women during pregnancy may be an inexpensive means of
reducing the rate of vertical HIV transmission, researchers suggest in
the December 12th issue of The Lancet.
"We postulate that important components of perinatal transmission of
HIV-1 include both preterm chronic chorioamnionitis and acute
chorioamnionitis at term," Dr. Robert L. Goldenberg and colleagues at
the University of Alabama at Birmingham explain. "We also believe
that a portion of this chorioamnionitis could be prevented in its
early stages with metronidazole alone or with other antibiotics."
They hypothesize that, because intrauterine bacterial infection
increases the levels of amniotic fluid cytokines, this leads to the
migration of HIV-infected leukocytes into the amniotic cavity.
When antibiotic treatment should be initiated and which patients
should be treated is not clear, they add. Dr. Goldenberg's team
suggests that HIV-positive women presenting with rupture of membranes
prior to labor, women with risk factors for chorioamnionitis and those
with slow progression of labor may be good candidates for antibiotic
treatment.
Antibiotics and microbicide treatments added to antiretroviral
regimens may result in small benefits for HIV-positive pregnant women
in developed countries. The real potential value would be for women
in developing countries, were antiretroviral treatment is unavailable,
they point out.
Dr. Goldenberg's team estimates that in countries of sub-Saharan
Africa, the total cost of antibiotic treatment would be $10.00 per
woman, and the cost of microbicide treatment would be even less. They
also suggest that the use of antibiotics to reduce chorioamnionitis
associated with HIV transmission may "nicely complement" short-course
antiretroviral regimens.
Lancet 1998;352:1927-1930.
el
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Dr. Eberhard W. Lisse\ / Swakopmund State Hospital
<el@lisse.NA> * | Resident Medical Officer
Private Bag 5004 \ / +264 81 1246733 (c) 64 461005(h) 461004(f)
Swakopmund, Namibia ;____/ Domain Coordinator for NA-DOM (el108)
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