E-drug: NYTimes: Cheaper Drug Prevents H.I.V. in Newborns
-------------------------------------------------------------------------
[Copied as fair use from New York Times. KM]
July 14, 2002
Cheaper Drug Prevents H.I.V. in Newborns, Study Shows
By LAWRENCE K. ALTMAN
BARCELONA, Spain, July 13 � A new study has shown that a simple and
inexpensive drug given just once after birth can protect many infants from
infection with the virus that causes AIDS, South African researchers
reported at the 14th International AIDS Conference that ended here on
Friday.
In the study, babies who were given a single dose of the AIDS drug
nevirapine within 24 hours after birth were no more likely to become
infected with H.I.V. than those given another drug, AZT, for the first six
weeks of life.
One dose of nevirapine costs 75 cents. A six-week course of AZT costs about
$40, said Dr. Glenda Gray, the head of the team that reported the study.
Dr. Gray said her team was using the new regimen at the Chris Hani
Baragwanath Hospital in Soweto.
The findings, she said in an interview, "provide policy makers an
alternative" for pregnant women. But she added that the findings needed to
be confirmed in additional studies before the regimen was more widely
adopted.
Giving nevirapine to a woman during labor and then to her newborn is
considered the most feasible way to prevent transmission of H.I.V. from an
infected mother to her newborn in developing countries, Dr. Gray said. She
said her team undertook the study because she and other pediatricians did
not know how effective preventive therapy would be if they gave nevirapine
only to a newborn and not to the mother.
So Dr. Gray, Dr. James McIntyre and their team devised a study to compare
nevirapine with AZT among newborns whose mothers chose not to take
anti-H.I.V. therapy during pregnancy or labor.
From October 2000 through February 2002, the researchers tested the mothers
of the 781 infants in the study for evidence of H.I.V. during labor or
delivery. Infected mothers who chose preventive therapy were not included in
the study.
For scientific comparison, infected mothers who rejected therapy for
themselves agreed to let the statistical equivalent of a coin toss determine
which therapy their babies would receive. Half were given the single dose of
nevirapine, the other half AZT for six weeks.
The researchers found that of the babies who tested negative for H.I.V. at
birth, 7.3 percent of those receiving nevirapine became infected, as against
10.7 percent of those receiving AZT. Statistical analysis showed that the
difference could be a result of chance.
But as Dr. Gray said, "for 75 cents you get as much effectiveness as $40."
The study found that the single dose of nevirapine protected a breast-fed
baby from infection for six weeks. Earlier studies have suggested that most
infections transmitted through breast milk occur in the first six weeks of
life.
The risk of infection increased if the mother breast-fed and the infant
received AZT. Dr. Gray speculated that one reason for the difference was
that AZT irritated an infant's stomach, allowing easier entry of H.I.V.
--
To send a message to E-Drug, write to: e-drug@usa.healthnet.org
To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@usa.healthnet.org
Information and archives: http://www.healthnet.org/programs/edrug.html