{"id":334,"date":"2008-12-27T08:30:12","date_gmt":"2008-12-27T07:30:12","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=334"},"modified":"2013-08-23T12:46:31","modified_gmt":"2013-08-23T12:46:31","slug":"four-weeks-of-antiretroviral-prophylaxis-is-sufficient-for-hiv-exposed-infants","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/334","title":{"rendered":"Four weeks of antiretroviral prophylaxis is sufficient for HIV-exposed infants"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p><strong>A study conducted at three Dublin Hospitals looked at 4 vs 6 weeks ARV prophylaxis for HIV-exposed infants.<\/strong><\/p>\n<p>US guidelines currently recommend 6 weeks ARV prophylaxis for infants, but this is not evidence based. The investigators suggest that the potential benefits of the shorter duration include greater acceptability, adherence, reduced toxicity and cost.<\/p>\n<p>The investigators performed an audit of the Irish PMTCT programme between January 1999 and December 2007. In this programme, prophylaxis is given according to infant risk: AZT (4mg\/kg BD) or NVP (2mg\/kg x 2 doses) plus AZT\/3TC, for 4 weeks rather than 6 weeks.<\/p>\n<p>In this programme, infants received AZT unless mothers had received &lt;4 weeks ART in pregnancy, were non adherent, had detectable viral load, had prolonged rupture of membranes or other transmission risks were identified. Infants were categorised HIV-negative if, post prophylaxis, they have two negative DNA PCR tests, the second at =3 months of age. The investigators found, there were 868 pregnancies, during the study period, which included 9 twin pregnancies. The women in the study were 79% African, 20% Irish and 1% other nationalities. There were 874 live births, including 5 neonatal deaths = 48 hrs (1 preterm, 2 birth asphyxia, 1 dysmorphic and1 sepsis) and 3 infant deaths (2 SIDS, 1 structural heart defect).<\/p>\n<p>ARV prophylaxis was given to 869 infants and they all completed the 4-week course. 9\/869 infants were HIV-positive, 826 HIV-negative and 34 of indeterminate status, including 2 late infant deaths; 1SIDS at 2 months and 1cardiac. 32 infants with at least one negative HIV PCR at = 6 weeks of age, including 23 at six weeks, were lost to follow up prior to 3 month testing.<\/p>\n<p>Based on data for 835 infants with known HIV status, the investigators found a TR of 1% (95% CI 0.98-1.019). Of these 8\/9 HIV-positive infants were born to women who presented late to antenatal care; 6\/8 women had &lt;6 weeks ART and 2\/8 were non adherent.<\/p>\n<p>The investigators wrote: &#8220;Four weeks neonatal ART component has comparable efficacy to 6 weeks treatment with potential for less toxicity and cost savings.&#8221;<\/p>\n<p>Reference:<\/p>\n<p>Ferguson W, Goode M, Walsh A et al. Four weeks neonatal antiretroviral therapy (ART) is sufficient to optimally prevent mother to child transmission (PMTCT) of HIV. 48th ICAAC, 25-28 October 2008. Washington. Abstract H-459.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base A study conducted at three Dublin Hospitals looked at 4 vs 6 weeks ARV prophylaxis for HIV-exposed infants. US guidelines currently recommend 6 weeks ARV prophylaxis for infants, but this is not evidence based. The investigators &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,35],"tags":[102],"class_list":["post-334","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pmtct-and-maternal-health","tag-icaac-48th-2008"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/334","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=334"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/334\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=334"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=334"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}