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Human Immunodeficiency Virus...

PEDIATRICS Vol. 109 No. 4 April 2002, pp. e60

ELECTRONIC ARTICLE

Zidovudine and Perinatal Human Immunodeficiency Virus Type 1 Transmission: A Population-Based Approach

Norma S. Harris, PhD, MSPH*, Shirley J. Thompson, PhD*, Robert Ball, MD, MPH{ddagger}, James Hussey, PhD* and Francisco Sy, MD, DrPH*

* Department of Epidemiology and Biostatistics, University of South Carolina, School of Public Health, Columbia, South Carolina
{ddagger} Division of Epidemiology, Department of Health and Environmental Control, Columbia, South Carolina

--> Objective. This study examined the impact of the full 3-arm zidovudine regimen on the perinatal transmission of human immunodeficiency virus type 1 (HIV-1) using population-based data.

Methods. We retrospectively ascertained information on zidovudine prescription and other characteristics of HIV-infected pregnant women and children for birth cohort years 1993, 1995, 1996, and 1997 using HIV/acquired immunodeficiency syndrome registry data from a state health department supplemented by medical record reviews.

Results. The transmission rate decreased from 12.5% in 1993 to 4.6% in 1997. The proportions of HIV-1-infected mothers and children who were prescribed all 3 arms of zidovudine increased from 68% in 1995 to 93% in 1997. Unadjusted and adjusted odds ratios for the relationship between the prescription of 3 arms of zidovudine and the infants’ HIV status were 0.19 (95% confidence interval: 0.05–0.84) and 0.15 (95% confidence interval: 0.02–0.96), respectively.

Conclusion. Perinatal HIV-1 transmission rates have decreased over time. This study demonstrates the effectiveness of the rapid implementation of the United States Public Health Service recommendations for the comprehensive use of zidovudine among HIV-1-infected pregnant women in a predominantly rural state.

Key Words: HIV infection • disease transmission • prevention and control • zidovudine • female • infant • newborn • population surveillance

Abbreviations: HIV, human immunodeficiency virus • AIDS, acquired immunodeficiency syndrome • ACTG 076, AIDS Clinical Trial Group 076 • USPHS, United States Public Health Service • STD, sexually transmitted disease • OR, odds ratio • CI, confidence interval

Received for publication Sep 27, 2001; Accepted Dec 19, 2001.




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