|HIV drugs||AZT/PIs||Ineffectiveness||Perinatal transmission|
|Chorioamnionitis and pregnancy outcome in HIV-infected African women.|| ||Ladner J et al.
| ||The transmission rate among 561 African women given neither antiretroviral drugs nor placebos was 12%. That’s lower than the 13.1% rate triumphantly claimed by Guay as the benefit of administering nevirapine.|
| ||J Acquir Immune Defic Syndr. 1998 Jul 1;18(3):293-8.||1998|
|Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial.|| ||Shaffer N, Chuachoowong R, Mock PA, Bhadrakom C, Siriwasin W, Young NL, Chotpitayasunondh T, Chearskul S, Roongpisuthipong A, Chinayon P, Karon J, Mastro TD, Simonds RJ.
| ||In the Shaffer study of the effect of short-course AZT administration on mother to child transmission, placebo administration reduced ‘transmission’ at one hospital 14.3% and at another 23.7%. The estimated transmission risks were 9.4% (95% CI 5.2-13.5) on zidovudine and 18.9% (13.2-24.2) on placebo (p=0.006; efficacy 50.1% [15.4-70.6]).|
| ||Lancet. 1999 Mar 6;353(9155):773-80.||1999|
|The trouble with nevirapine|| ||Brink Anthony
| ||The American CDC, studying the effect of AZT for the same purpose [prevention of perinatal transmission of hiv], reported that placebos apparently reduced the transmission rate (18.6%) when compared with untreated controls (24.2%) – leading the researchers to observe: “The lower than expected background transmission rate highlights the importance of having included a randomised, concurrently enrolled, untreated control group. Had the test regimen been inactive, a transmission rate of 18.6% may have suggested some efficacy when compared with historical data.”|
|Acceptability and impact of zidovudine for prevention of mother-to-child human immunodeficiency virus-1 transmission in France.|| ||Mayaux MJ et al.
| ||“One puzzling finding in our study was the trend toward a decline in the mother-to-child transmission rate 2 years before zidovudine prevention was introduced. None of the numerous variables recorded explains this gradual decline, which was unaffected by the mode of delivery [vaginal or cesarean] and which zidovudine [AZT] prophylaxis considerably amplified”|
| ||J Pediatr. 1997 Dec;131(6):857-62.||1997|
|Twenty-four month efficacy of a maternal short-course zidovudine regimen to prevent mother-to-child transmission of HIV-1 in West Africa.|| ||Leroy V et al.
| ||“At 24 months, overall CR [cumulative risk] of MTCT [Mother-to-child transmission of HIV] were 22.5% in the zidovudine [AZT] and 30.2% in the placebo group...Among children born to women with CD4 cell counts <500/ml at enrollment, CR of MTCT were similar, 39.6% in the zidovudine and 41.3% in the placebo group. Among children born to women with CD4 cell counts >= 500/ml, CR of MTCT were 9.1% in the zidovudine and 22% in the placebo group”|
| ||AIDS. 2002 Mar 8;16(4):631-41.||2002|
|Maternal vitamin A deficiency and mother-to-child transmission of HIV-1.|| ||Semba RD, Miotti PG, Chiphangwi JD, Saah AJ, Canner JK, Dallabetta GA, Hoover DR.
| ||"We conducted a study of vitamin A status in pregnant women as a risk factor for mother-to-child transmission of HIV in Malawi. Serum vitamin A, height, weight, CD4 T-cell counts, and duration of breastfeeding were measured in 338 HIV-positive mothers whose infant's HIV serostatus was known. Mother-to-child transmission of HIV was 21.9% among mothers whose infants survived to 12 months of age. Mean vitamin A concentration in 74 mothers who transmitted HIV to their infants was lower than that in 264 mothers who did not transmit HIV to their infants (0.86 [0.03] vs 1.07 [0.02], p < 0.0001). We divided HIV positive mothers to 4 groups, those with vitamin A concentrations of less than 0.70, between 0.70 and 1.05, between 1.05 and 1.40, and greater than or equal to 1.40 mumol/L. The mother-to-child transmission rates for each group were 32.4%, 26.2%, 16.0%, and 7.2%, respectively (p < 0.0001). Maternal CD4 cell counts, CD4%, and CD4/CD8 ratio were also associated with increased mother-to-child transmission of HIV. Maternal age, body-mass index, and breastfeeding practices were not significantly associated with higher mother-to-child transmission. Our study suggests that maternal vitamin A deficiency contributes to mother-to-child transmission of HIV."|
| ||Lancet 1994 Jun 25;343(8913):1593-7||1994|
|Vitamins in HIV disease progression and vertical transmission.|| ||Fawzi WW, Hunter DJ.
| ||Regarding vitamins in HIV disease progression and vertical transmission, researchers from the Harvard School of Public Health state: “The higher rates of HIV progression and vertical transmission in developing countries coincide with similarly higher rates of malnutrition and vitamin deficiencies, indicating that HIV infection, may be modified by nutritional status... Numerous observational studies report inverse association between vitamin status, measured bio-chemically or as levels of dietary intake, and the risk of disease progression or vertical transmission... Adequate vitamin status may also reduce vertical transmission through the intra-partum and breastfeeding routes by reducing HIV viral load in lower genital secretions and breast milk,”|
| ||Epidemiology 1998; 9: 457-466.||1998|
|Vitamin A relationships to mortality in HIV disease and effects on HIV infection: recent and late breaking studies.|| ||Landesman S.
| ||“Women who had increasing serum retinol levels over time, however, were at a lower risk, whereas women who had declining serum retinol were at a higher risk of transmitting the virus”|
| ||Presentation at forum, Lawtom Chiles International House, National Institutes of Health, Bethesda, MD, May 16, 1996.||1996|
|Effects of maternal vitamin A deficiency on infant mortality and perinatal HIV transmission.|| ||Graham N et al.
| ||“In Rwanda, low levels of serum vitamin A among HIV-infected women were associated with increased risk of ... perinatal HIV-transmission"|
| ||Presentation at the National Conference on Human Retroviruses and Related Infections: December 12-16, 1993; Baltimore, Maryland, USA.||1993|
|Interventions to prevent vertical transmission of HIV-1: effect on viral detection rate in early infant samples.|| ||Dunn DT et al.
| ||“[422 children born from HIV + mothers] Neither the use of maternal nor neonatal antiretroviral therapy was associated with the detection rate of HIV-1 at birth [yet antiretroviral therapy is supposed to reduce the likelihood of infection]”|
| ||AIDS. 2000 Jul 7;14(10):1421-8.||2000|
|Genital tract Human Immunodeficiency Virus Type 1 (HIV-1) shedding and inflammation and HIV-1 env diversity in perinatal HIV-1 transmission.|| ||Panther LA et al.
| ||“Of these 24 women, 7 transmitted HIV-1 to their infants and 17 did not [yet, these women were provided with antiviral therapy that is supposed to reduce transmission from about 25% to about 8%!]”|
| ||J Infect Dis. 2000 Feb;181:555-63.||2000|
|Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal HIV transmission: a randomized trial [.doc file incomplete].|| ||Dorenbaum A et al.
| ||“Detection of HIV infection occurred in 19 newborns, 9 (1.4%) of 631 deliveries in the nevirapine arm and 10 (1.6%) of 617 deliveries in the placebo arm”|
| ||JAMA. 2002 Jul 10;288(2):189-98.||2002|