Short-Term AZT Use in Pregnancy Hailed

In findings that could prove important for controlling the spread of AIDS in developing nations, short-term use of the drug AZT for infected women late in pregnancy and during delivery reduced transmission to infants by half, U.S. and Thai health officials announced Wednesday.

This is significant because the therapy involves a shorter duration and much less expensive regimen of the drug than that typically prescribed for infected pregnant women in the United States.

Thus, it offers “real hope” to countries that previously had no realistic treatment options to prevent HIV transmission from infected mother to fetus, said officials from the Centers for Disease Control and Prevention in Atlanta and the Ministry of Public Health of Thailand.

CDC estimates that every day, 1,600 HIV-infected babies are born worldwide.

The short course of treatment administered to women in the study costs about $80, compared with the $800 to $1,000 for the standard recommended therapy given in the United States.

In the United States, oral AZT therapy is started as soon as possible after 14 weeks’ gestation and continues throughout pregnancy in doses taken five times daily. The drug also is administered intravenously during labor and then given to the newborn orally four times a day for six weeks.

In the study, women took higher doses of the drug orally twice a day for the last four weeks of pregnancy and continued taking the drug orally during labor. The drug was not given to the infants.

The preliminary results were so compelling that all pregnant women enrolled in the study--which also includes a group of women in Abidjan, Ivory Coast--will now be offered the drug.

Despite the vast differences between the two regimens, access to AZT still could prove formidable in developing countries, officials acknowledged. The cost is “still much higher than a lot of countries can afford,” said Dr. Martha Rogers, associate director for science in CDC’s AIDS division. But, she added, the study results likely would boost efforts to “pressure the developing world, donor agencies and drug companies to provide these resources. Hopefully, that’s going to happen.”

Of the 391 babies born to women in the study, 198 were born to mothers who took a medically worthless placebo and 193 to those who took AZT.

There were 35 infected babies in the placebo group, compared with 17 in the AZT group, roughly half, which Rogers called “a remarkable difference.”