Routine Use of Antiretroviral Therapy to Prevent Mother-to-Child HIV Transmission in the Kafue District of Zambia

Summary

The investigators will enroll a cohort of HIV-infected pregnant women accessing PMTCT services, to better understand the incremental benefits (e.g. reduction in HIV transmission, improvements in HIV-free survival) and risks (e.g. drug toxicities) of the routine HAART strategy, in comparison to HIV-infected pregnant women accessing the Zambian Standard of Care services. The investigators will test the hypothesis that routine use of HAART produces significant reductions in HIV transmission rates, with only minimal side effects.

Timeline

Start

2009-05

Primary completion

2012-01

Completion

2012-01

Outcome

Met primary endpoint

paper When we considered the composite outcome of HIV infection or death, similar trends were observed in the overall study population (RR: 3.4, 95% CI: 1.6-7.6; P = 0.002) PMID 23324656 ↗

paper When compared with PMTCT services based on antenatal zidovudine and peripartum nevirapine, the provision of maternal combination prophylaxis imparted measurable health benefits to HIV-exposed infants. PMID 23324656 ↗

Publications

• Results Gartland MG, Chintu NT, Li MS, Lembalemba MK, Mulenga SN, Bweupe M, Musonda P, Stringer EM, Stringer JS, Chi BH. Field effectiveness of combination antiretroviral prophylaxis for the prevention of mother-to-child HIV transmission in rural Zambia. AIDS. 2013 May 15;27(8):1253-62. doi: 10.1097/QAD.0b013e32835e3937.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Lamivudine	Other / unclassified	—	—
Subject	Lopinavir	Other / unclassified	—	—
Subject	Nevirapine	Small molecule	—	—
Subject	Ritonavir	Other / unclassified	—	—
Subject	Stavudine	Other / unclassified	—	—
Subject	Zidovudine	Small molecule	—	—

Indications