E-DRUG: Simple, affordable prevention of vertical HIV transmission

E-DRUG Simple, affordable prevention of vertical HIV transmission
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[Moderators Comment: This result has previuosly been reported on E-DRUG as
"E-DRUG: nevirapine for mother to child HIV prevention" by Wilbert
Bannenberg with the details of the results of the trial. What interests me
is that in the comparison group who received AZT (zidovudine) HIV infection
occurred in 25.1% of cases. This is 7% MORE than the rate of transmission
in the control group in the Thailand study which demonstrated AZT efficacy
to reduce transmission. The question this raises to me is that the disease
may be different in differing situations and before global recommendations
are made, I hope that we will have more data than from one trial to make
these global recomendations. Also if AZT (zidovudine) is so ineffective in
preventing transmission as shown in this trial, should it be on the WHO
Model List of essential Drugs for this indication? Richard Laing Co-Moderator]

I wanted to make sure that everybody is aware of the important results of the
recent study about Nevirapine for the prevention of mother to child
transmission of HIV.

Investigators from the US (Johns Hopkins University and University of
Wahington) and Makerere University in Uganda compared the short course of AZT
to "single dose" Nevirapine (one dose to the mother and one dose to the
infant). After 3 months only 13% of infants in the Nevirapine group were HIV
infected compared to 25% in the AZT group.

The study is not published yet but an executive summary is available at
www.niaid.nih.gov/cgi-shl/simple/default.cfm

These findings have tremendous impact for developing countries. Besides being
more effective, the Nevirapine course is also estimated to be almost 70 times
cheaper (I heard about $4/treatment) than a short course of AZT. Nevirapine
is marketed by Boehringer Ingelheim.
According to the National Institute of Allergy and Infectious Diseases
(NIAID) which sponsered the study, the intervention "potentially could
prevent some 300,000 to 400,000 newborns per year from beginning life
infected with HIV" if implemented widely in developing countries.

Tido von Schoen-Angerer, MD
Medecins sans frontieres
tavschoen@aol.com

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