Prevention of Mother-to-Child Transmission of HIV-1 Using Highly Active Antiretroviral Therapy in Rural Yunnan, China

作者：Zengquan Zhou, Kathrine Meyers, Xia Li, Qingling Chen, Haoyu Qian, Yunfei Lao, Elvin Geng, Yishan Fan, Shaomin Yang, Michael J. Chiu, David D. Ho · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2010 · DOI：10.1097/qai.0b013e3181c7d47b · 被引用次数：18 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、HIV/AIDS drug development and treatment

OBJECTIVE: To demonstrate that the use of highly active antiretroviral therapy (HAART) to interrupt transmission of HIV-1 from mother to baby is effective, safe, and feasible in a remote rural region of China. METHODS: Between November 2005 and May 2009, we enrolled 279 HIV-1-infected pregnant women to receive HAART to interrupt transmission of HIV-1 to their newborns across 16 counties in Yunnan. All women were started on triple combination therapy and submitted to regular blood draws to monitor CD4 T cells and viral load in their blood plasma. Infants received a single dose of nevirapine at birth and 1 or 4 weeks of zidovudine depending on the length of the mother's regimen. Exclusive formula feeding was recommended, and families were provided with 12-month supply of formula. Mothers and infant pairs were followed for 12-18 months postdelivery. RESULTS: Of 279 enrolled HIV-infected women, 222 (79.6%) were identified and started treatment by 28 weeks of pregnancy. Viral load was undetectable at time of delivery for 62.4% (136 of 218) at delivery, with a mean 1.76 log viral load reduction between enrollment and delivery. Two of 193 babies (1.0%) who have already been tested became infected with HIV-1. Seven of 223 babies have died. By Kaplan-Meier analysis, cumulative one-year survival was 96.3%. CONCLUSIONS: The project demonstrated that HAART for all infected pregnant women is effective with a vertical transmission rate of approximately 1%. Thus, this project provides a mod...