Acceptability and impact of zidovudine for prevention of mother-to-child human immunodeficiency virus-1 transmission in France.
We studied the propagation and the impact of zidovudine prevention on the human immunodeficiency virus-1 transmission rate from infected mothers to their infants in the French nationwide prospective cohort.
Infection was diagnosed in the children on the basis of at least two positive human immunodeficiency virus-1 polymerase chain reaction tests, culture, or both.
The transmission rate among treated women was compared with that among untreated women during the same period and with that among women enrolled in the cohort since 1986.
The impact of zidovudine was analyzed according to the women's clinical and biologic characteristics, the mode of delivery, and use of zidovudine therapy before the pregnancy.
Nearly 90% of women were treated as soon as the second half of 1994.
In 1994 and 1995,80% of mother-child pairs received at least one of the three phases of preventive treatment.
Among the 663 mothers enrolled during these 2 years, only six refused the treatment.
Zidovudine treatment was associated with a reduction in the transmission rate of nearly two-thirds, from 14% ± 6% to 5% ± 2% (p<0.01).
The degree of reduction was not influenced by the maternal CD4+cell count or p24 antigenemia at delivery.
Zidovudine treatment of the mother before the pregnancy considerably reduced the impact of preventive therapy ; the transmission rate was significantly higher among pretreated mothers (20% versus 5%, p<0.01) even after adjusting for maternal CD4+cell count. (...)
Mots-clés Pascal : Virus HIV1, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Infection, Transmission mère enfant, Zidovudine, Chimiothérapie, Prévention, Traitement, Efficacité traitement, Nouveau né, Homme, Epidémiologie, Pyrimidine nucléoside, Didésoxynucléoside, Gestation pathologie, Virose
Mots-clés Pascal anglais : HIV-1 virus, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Infection, Mother to child transmission, Zidovudine, Chemotherapy, Prevention, Treatment, Treatment efficiency, Newborn, Human, Epidemiology, Pyrimidine nucleoside, Dideoxynucleoside, Pregnancy disorders, Viral disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0090458
Code Inist : 002B02S05. Création : 14/05/1998.