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1st appeared 8 September 1999

New Drug Intervention Feasible for Reducing HIV Transmission in Africa

Preventing HIV transmission from mother to child in sub-Saharan Africa -- where 90 percent of children with HIV live -- may be cheaper and easier than previously thought, according to researchers in the United States and Uganda.

The researchers used a computer model to evaluate the cost-effectiveness of using nevirapine, an antiviral drug that recently showed remarkable reductions of HIV transmission from mother to child. The nevirapine regimen was significantly cheaper and more effective than three similar drug treatments that have recently been tested. The study results appear in the current issue of The Lancet.

"Identifying economical interventions to reduce the ongoing devastation of AIDS is an urgent public health priority," said James G. Kahn, UCSF professor of epidemiology and biostatistics, AIDS Research Institute, Institute for Health Policy Studies, and co-author of the paper. "Our study shows that reducing HIV transmission from mother to child in developing countries is economically feasible. It lends strong support to HIV prevention efforts."

Although long-term treatment with the antiviral drug AZT is the most effective way to prevent HIV transmission in industrial countries like the United States, it is expensive and must be started early in pregnancy. Most African mothers cannot afford AZT and often do not get prenatal care, thereby missing their chance to begin treatment.

To address the needs of developing countries, scientists have developed more feasible and less expensive "short-course" drug regimens that can be started late in pregnancy. All involve different doses and timing of antiviral drugs. The newest treatment uses nevirapine and has recently been tested in a clinical trial called HIVNET 012. The nevirapine regimen resulted in almost 50 percent fewer HIV cases in infants compared to a short-course AZT treatment. Results of the trial are also published in the current issue of The Lancet.

"The results were pretty stunning," said Elliot Marseille of Health Strategies International and lead author of the study.

Links:

Full UCSF press release

AIDS Research Institute

The Lancet

Related Daybreak stories:

Cost-Effective Treatment Possible in Africa for HIV-Positive Pregnant Women if Drug Prices Lowered

Source: Rebecca Sladek Nowlis, News Services


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