办事指南

Brighter future

点击量:   时间:2017-10-03 06:01:10

By Michael Day A SHORT, cheap course of the anti-AIDS drug AZT in the final month of pregnancy halves a mother’s risk of passing HIV to her child. The results of a trial of the treatment in Thailand suggest that this is an effective and affordable way to reduce the number of babies born with HIV in developing countries. “With 1600 babies born every day with HIV, most of them in the developing world, we need this treatment as soon as possible,” says Joseph Saba, head of the UNAIDS Working Group on the Prevention of Mother to Child HIV. Four years ago, research showed that a three-month course of AZT cut the risk of passing HIV to the baby by almost 70 per cent—from one in six to one in twenty. This treatment is now standard in wealthy Western nations. However, the treatment was thought too complex and, at $800 a patient, too expensive for most developing countries. The trial in Thailand aimed to check whether a shorter course of the drug would be effective. The study of 393 pregnant women, funded by the US Centers for Disease Control and Prevention, found that women who took AZT during the last four weeks of pregnancy and during labour were 51 per cent less likely to transmit HIV to their child than those receiving dummy pills. The course costs a tenth of the standard treatment. As soon as the results of the study were announced, the CDC and the US National Institutes of Health ordered an immediate end to the placebo arm of the trial, which had attracted strong criticism (This Week, 17 May 1997, p 14). Sabo argues that it was necessary to prove how effective the shorter treatment was. UNAIDS and the French national AIDS research agency, ANRS, also told investigators in the trials they sponsor to halt placebo treatment. “Using placebo controls after the Thailand results cannot be justified,” says Saba. Representatives from the CDC, NIH,