Just one dose of a generic AIDS drug can help prevent the spread of the disease from mother to baby in four out of five cases, a remarkable finding that could have wide impact in the developing world, doctors said Friday.
A research team led by Marc Lallemant of the Program for HIV Treatment and Prevention in Chiang Mai, Thailand, found the drug nevirapine was “highly effective” in reducing mother-to-child transmission of HIV, the AIDS virus.
An editorial in The New England Journal of Medicine, which will publish the study next week, called the reduction "astonishing.” The Journal released the study early on the eve of a major international AIDS conference in Bangkok.
AIDS experts from around the world will meet there to try to come up with a better agenda for fighting the incurable virus that infects more than 43 million people worldwide and has killed more than 25 million.
Infection rate reduced
Among more than 1,800 pregnant women in Thailand, all of whom were infected with HIV, Lallemant and colleagues were able to cut the mother-to-child infection rate to 1.1 percent by giving nevirapine to mothers during labor and to babies just after delivery.
The infection rate was 6.3 percent when both mother and child were given a placebo.
All the mothers were already receiving treatment with the anti-AIDS drug AZT. In addition, none of the babies was breast-fed. Of the 700,000 children infected with HIV worldwide last year, about 315,000 have gotten it through breast-feeding.
The findings are important in developing countries because the treatment is relatively convenient and inexpensive. In wealthier areas of the world where state-of-the-art HIV medicines are available, the findings will be less relevant.
'A regimen of striking simplicity ...'
“Single-dose nevirapine is a regimen of striking simplicity, efficacy, and affordability,” Hoosen Coovadia said in the Journal editorial.
Coovadia, of the Nelson Mandela School of Medicine in Durban, South Africa, said the single dose of nevirapine should not be given to pregnant women in developed countries who are already being treated with a combination of anti-HIV drugs. Those newer drugs are so effective, the chance of passing the virus to the child is low, Coovadia said.
HIV infects 1.3 percent of pregnant women in Thailand, the Lallemant team said.
Nevirapine is also known as NVP or by its brand name, Viramune. It is manufactured by privately held Boehringer Ingelheim.
In a study released a week ago, Nevirapine was one of three generic drugs shown to be effective against AIDS when combined into a single pill and given twice a day to volunteers in Cameroon. That study, by the French National Agency for Research on AIDS, was published in The Lancet medical journal.
