การใช้ยา Zidovudine และ Nevirapine เพื่อป้องกันการถ่ายทอดเชื้อเอชไอวีจากมารดาสู่ทารกในโรงพยาบาลนครปฐม

บทคัดย่อ

Objective : To evaluate the efficacy and side effects of three antiretroviral treatment regimens in prevention of mother to-child transmission of HIV in Nakhonpathom Hospital. In one group; mothers received zidovudine (AZT) + nevirapine (NVP), infants received AZT + NVP (NVP-NVP regimen); in another, mothers received AZT+ NVP, infants received AZT+placebo (NVP-PB regimen) and in the last, mothers received AZT + PB(placebo), infants received AZT + PB (PB-PB regimen).

Materials and methods : we conducted a prospective randomized double-blind controlled study in HIV- infected pregnant women in Nakhonpathom Hospital. After enrollment, history taking, physical examining and laboratory evaluation were performed at initial visit. The subjects were randomly assigned to one of three studied groups, agreed not to breast-feed and were followed through 18 months after delivery.

Results : 82 subjects were enrolled. 30 subjects were randomly assigned to the NVP-NVP group, 29 subjects in the NVP-PB group and 23 subjects in the PB-PB group. 2 subjects in the PB-PB group were excluded because of fetal death and another case wanted to leave the study. Infected infants in the NVP-NVP, NVP-PB and PB-PB group were 1, 0 and 2 cases which represented transmission rates of 3.33, 0 and 9.52% respectively. The transmission rates between studied groups were not statistically different (p = 0.214). No adverse effects from nevirapine had been detected in both mothers and infants. Anemia were founded in 13.75% and 6.25% of mothers and infants respectively.

conclusion : NVP added to AZT treatment in mothers and infants or added to mothers only did not reduce mother-to-child transmission rate of HIV compared to AZT treatment in mothers and infants alone. No adverse effect of NVP be founded.