Intrapartum Zidovudine Infusion Alone Failed to
Reduce Both Maternal HIV-1 Viral Load and HIV-1
Infection in lnfantt
SOMPOP LIMPONGSANURAK,M.D.,M.P.H.*, PIMOLRATN THAITHUMYANON,M.D.**,
USA THISYAKORN, M.D.**, KIAT RUXRUNGTHAM, M.D.***,
SURASITH CHAITHONGWONGWATTHANA,M.D.*, PAHSUVADN KONGSIN,M.D.****,
URAIVAN TAROUNOTAI, M.D.*****, NOPADOL CHANTHEPTAEWAN, M.D.******,
TANEENAT TRIRA TWERAPONG, M.D.*******, SASIWIMOL UBOL YAM, B.Sc. (Med Tech), M.Sc. (Med Tech)********,
PRAPHAN PHANUPHAK, M.D., Ph.D.***
Affiliation : * Department of Obstetrics and Gynecology,
* * Department of Pediatrics,
*** Department of Medicine, Faculty of Medicine, Chulalongkom University, Bangkok 10330,
**** Department of Obstetrics and Gynecology,
*****Department of Pediatrics, Vajira Hospital, Bangkok 10300,
****** Department of Obstetrics and Gynecology,
*******Department of Pediatrics, Taksin Hospital, Bangkok 10600,
******** HIV-NAT, the Thai Red Cross Society, Bangkok 10330, Thailand.
t This study was supported by the Bureau of Planning and Policy, Ministry of University Affairs, Thailand.
AbstractA pilot clinical trial to assess the efficacy of intrapartum zidovudine (ZDV) infusion alone
in the reduction of maternal viral load and its potential role in preventing vertical transmission of
HIV -1. Twenty six, asymptomatic antiretroviral na'ive HIV -1 infected pregnant women who had
no prior antenatal care and were in labor were enrolled. Each patient received ZDV infusion at
the rate of 2 mg/kg within the first hour. ZDV was then continuously infused at I mg/kg/h until
delivery. Maternal plasma HIV-1 RNA prior to the commencement of ZDV infusion and within
an hour after delivery were measured. HIV-1 transmission was documented by nested polymerase
chain reaction in infants at six months of age. Median maternal plasma HIV -1 RNA prior to the
ZDV infusion and after delivery was 29,40 I and 32,555 copies/m1 respectively, (p>0.05). The
estimated HIV -1 transmission rate was 19.2 per cent (95% CI = 4-34). This result suggested that
in asymptomatic HIV -1 infected pregnant women who were antiretroviral nai've and had no prior
antenatal care, intrapartum ZDV infusion alone failed to reduce maternal HIV -1 viremia and the
transmission rate of HIV-1.
Keywords : Intrapartum, Zidovudine, HIV -1 Infection, Infant
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