Evaluation of 4 Weeks' Neonatal Antiretroviral Prophylaxis as a Component of a Prevention of Mother-to-Child Transmission Program in a Resource-Rich Setting
PURPOSE OF THE STUDY.
A 6-week course of neonatal antiretroviral prophylaxis has been standard in most developed countries. In the same settings, a 4-week rather than 6-week intervention might reduce toxicity and reduce cost.
The study involved a cohort that included all HIV-exposed live births in Ireland from January 1999 through December 2008 with a minimum of 18-months of follow-up.
This was a 10-year observational study of the Irish experience in their use of a 4-week rather than 6-week neonatal antiretroviral regimen.
Of the 916 infants with known outcome, 1% were infected. If analysis was limited to the 910 infants whose mothers received at least 4 weeks of antiretroviral therapy, the vertical transmission rate was 0.4%. These numbers are consistent with those found in other areas in which the standard 6-week regimen is followed.
The current clinical practice of using a 4-week neonatal antiretroviral prevention regimen seems to be as effective as a 6-week regimen.
Although it is reasonable to surmise that a 4-week regimen is as effective as a 6-week regimen in preventing vertical transmission of HIV, the data presented here are unlikely to convince the public health authorities of other countries to move in this direction. This was not a controlled trial, and the patient population might differ in other countries.
- Copyright © 2011 by the American Academy of Pediatrics