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Highly active antiretroviral therapy versus zidovudine for prevention of mother-to-child transmission in a programmatic setting, Botswana

Dryden-Peterson, S.; Jayeoba, O.; Hughes, M.D.; Jibril, H.; Keapoletswe, K.; Tlale, J.; Modise, T.A.; Asmelash, A.; Moyo, S.; van Widenfelt, E.; Makhema, J.; Essex, M.; Shapiro, R.L.; Lockman, S.

Journal of Acquired Immune Deficiency Syndromes 58(3): 353-357

2011

ISSN/ISBN: 1525-4135
PMID: 21792062
DOI: 10.1097/qai.0b013e31822d4063
Document Number: 229098
Few studies have compared the programmatic effectiveness of the recommended strategies of antenatal highly active antiretroviral therapy (HAART) and zidovudine for prevention of mother-to-child transmission. We prospectively followed infants (93% formula fed) whose mothers who took either HAART (258 infants) or zidovudine (170 infants) during pregnancy in the Botswana national program. Overall, 10 infants (2.5%) acquired HIV--9 infants in the zidovudine group (5.5%, 95% confidence interval: 2.6% to 10.2%) and 1 infant in the HAART group (0.4%, 95% confidence interval: 0.0% to 2.2%). Maternal HAART was associated with decreased prevention of mother-to-child transmission (P = 0.001) and improved HIV-free survival (P = 0.040) compared with zidovudine (with or without single-dose nevirapine) in a programmatic setting.

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