Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission
Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission
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DOI：
10.1056/nejmoa0801941
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发表时间：
2008-07-10
影响因子：
158.5
通讯作者：
Taha, Taha E.
中科院分区：
文献类型：
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作者：
Kumwenda, Newton I.;Hoover, Donald R.;Taha, Taha E.
背景：迫切需要有效的策略来减少在资源有限的环境中通过母乳喂养传播 1 型人类免疫缺陷病毒 (HIV-1) 的母婴传播。方法：在马拉维布兰太尔开展的一项随机 3 期试验招募了正在哺乳婴儿的 HIV-1 感染妇女。出生时，婴儿被随机分配接受三种方案之一：单剂量奈韦拉平加 1 周齐多夫定（对照方案）或对照方案加奈韦拉平每日延长预防（延长奈韦拉平）或奈韦拉平加齐多夫定（延长双重预防）直至 14 周龄。使用 Kaplan-Meier 分析，我们评估了出生时 DNA 聚合酶链反应测定为 HIV-1 阴性的婴儿感染 HIV-1 的风险。 结果：在研究中的 3016 名婴儿中，对照组从 6 周到 18 个月的婴儿的 HIV-1 感染率始终较高。 9 个月时，对照组的 HIV-1 感染率（主要终点）估计为 10.6%，而延长奈韦拉平组为 5.2%（P
Background: Effective strategies are urgently needed to reduce mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) through breast-feeding in resource-limited settings.Methods: Women with HIV-1 infection who were breast-feeding infants were enrolled in a randomized, phase 3 trial in Blantyre, Malawi. At birth, the infants were randomly assigned to one of three regimens: single-dose nevirapine plus 1 week of zidovudine (control regimen) or the control regimen plus daily extended prophylaxis either with nevirapine (extended nevirapine) or with nevirapine plus zidovudine (extended dual prophylaxis) until the age of 14 weeks. Using Kaplan-Meier analyses, we assessed the risk of HIV-1 infection among infants who were HIV-1-negative on DNA polymerase-chain-reaction assay at birth.Results: Among 3016 infants in the study, the control group had consistently higher rates of HIV-1 infection from the age of 6 weeks through 18 months. At 9 months, the estimated rate of HIV-1 infection (the primary end point) was 10.6% in the control group, as compared with 5.2% in the extended-nevirapine group (P