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"15-Month Efficacy of Maternal Oral Zidovudine to Decrease
Vertical Transmission of HIV-1 in Breastfed African Children
(Research Letter)"
Lancet (12/11/99) Vol. 354, No. 9195, P. 2050
A comparison of a short regimen of oral zidovudine and a placebo
in West Africa tested the efficacy of zidovudine in preventing
mother-to-child transmission of HIV-1 infection. The 15-month
DITRAME ANRS 049a study, conducted in Abidjan, Cote d'Ivoire, and
Bobo-Dioulasso, Burkina Faso, of 431 women between September 1995
and February 1998 included 401 live births. Polymerase chain
reaction testing showed that at 15 months of age, 37 children in
the zidovudine group and 57 in the placebo group were infected
with HIV. The probability of being infected was lower in the
zidovudine group than the placebo one. The efficacy of
zidovudine in reducing mother-to-child HIV-1 transmission was
estimated to be about 30 percent after 15 months of follow-up
under exposure to breastfeeding. Although the researchers say
that further study is needed, they note that their findings
support the 1998 recommendation of short-course zidovudine, in
this case in African populations with high rates of
breastfeeding.
Reuters Health Information Services (12/22/99)
A national HIV prevention program geared towards the entire U.S.
population could be effective in preventing the spread of the
virus, a Syracuse University professor has concluded. Dr.
Michael Carey, director of the Center for Health and Behavior at
Syracuse, notes that such programs helped to effect a 20 percent
increase in condom use among young adults in Switzerland and a 90
percent condom use rate in brothels in Thailand. In the American
Journal of Health Promotion (1999;14:104-111), Carey asserts that
while prevention efforts generally take place in specific
settings, such as HIV counseling and testing sites and school sex
education programs, a more comprehensive community effort could
have a greater impact.
Reuters Health Information Services (12/22/99)
Italian researchers report that highly active antiretroviral
therapy (HAART) in children who have not previously been treated
with protease inhibitors can suppress HIV viral loads to under
400 copies/mL in many patients. The researchers studied 25
children being treated with stavudine, lamivudine, and indinavir.
After 18 months, the researchers found that more than 50 percent
of the children had HIV RNA levels under 400 copies/mL, including
nearly 90 percent of those with Centers for Disease Control and
Prevention class 2 infection and 72 percent of those with class 3
infection. The findings are reported in the December issue of
the Journal of Pediatrics (1999;135:655-656, 675-682).
PANA Wire Service (12/22/99)
The World Health Organization has been awarded $16.4 million from
the United Nations Foundation to help lower the number of child
deaths, prevent HIV infection among children, increase
vaccination rates, and child nutrition in eight nations in
Africa. The grant, which raises the foundation's contribution to
$51 million, will be used to increase community understanding
about what sick children need. Of the total, $2.4 million will
be used for increasing the management skills of immunization
program leaders, $5 million will be used for greater surveillance
and control of vaccine-preventable diseases, and $3.5 million
will be used to study the effects of zinc supplementation on
child mortality. The countries that will benefit from the new
funding are Madagascar, Malawi, Mali, Nigeria, Senegal, Tanzania,
Zambia, and Zimbabwe.
Australian Associated Press (12/22/99)
The Australian Red Cross Blood Service announced Wednesday that
it will start using next year a nucleic acid testing (NAT) system
to detect viruses in the blood supply. The Red Cross, using a
combination test from Chiron Blood Testing, plans to implement
the new system by mid-2000. The NAT assay, which screens for HIV
and hepatitis C virus, can reduce the average window period
between infection and the detection of a virus from 80 days to 22
days for hepatitis C, and from 22 days to 11 days for HIV.
Africa News Service (12/22/99)
Nigeria is organizing an international seminar to discuss the
spread of HIV in Africa. According to Nigerian Vice President
Atiku Abubakar, talks are also being held with the World Health
Organization and the World Bank in an effort to obtain assistance
for the fight against HIV. An estimated 25,000 Nigerians have
died from AIDS.
Notice: The CDC HIV/STD/TB Prevention News Update will not be published on Friday, December 24 and Monday, December 27 in observance of the Christmas holiday. Publication will resume on Tuesday, December 28.