New-borns safer with mothers on early ARV treatment

The latest findings suggest that a certain blend of antiretrovirals (ARV) taken late in pregnancy and continued six months into breast-feeding can lessen the transmission of HIV to breast-fed babies by over 40 per cent.

Existing WHO recommendations for HIV-positive women advises a short-course AVR regime during late pregnancy and around the time of delivery.   

The new research was presented by UNAIDS at the just concluded 5th International Aids Society Conference in Cape Town, South Africa (July 19-22). Thousands of health professionals and bureaucrats attended the annual event where several break-through studies were published.

The study, conducted between June 2005 and August 2008, involved 1,140 women from five locations within Africa from Burkina Faso, Kenya and South Africa. Titled ‘Kesho Bora’ (‘a better future’ in Swahili), the study looked at whether the transmission of HIV to infants during breastfeeding could be reduced.

Infection rates among babies were significantly lower when pregnant women, with a CD4 immune cell count of 200-500 cells/ mm3, were given a triple AVR combination of zidovudine, lamivudine and lopinavir/ritonavir. The women started taking the AVR therapy in their third trimester, continuing through birth and six months into breastfeeding.  

The WHO said its experts will examine the data and update the guidelines – expected to be released before the end of the year.

Meanwhile, medical charity MSF also released damning news indicating that some countries were running out of supplies for the much needed antiretroviral treatment. Disruptions in the supply of anti-retroviral (ARV) drugs and other essential medical items in at least six African countries are putting HIV patients’ lives at risk, MSF said.

Its teams in Uganda, conflict-ridden DR Congo, Zimbabwe, and Guinea are seeing stock-outs. In South Africa, the government budget for health was cut due to the financial crisis and finding alternative funding seems difficult in the short term, MSF said.

The disruptions are said to be a result of a shortage of in-country funding and delays by donor governments in fulfilling their commitments. Funding institutions such as the Global Fund and the US government’s PEPFAR programme face budget caps or uncertainty in the replenishment of funding.

“All around us, clinics stop enrolling patients because there are just not enough ARV supplies,” said Eric Goemaere, MSF Head of Mission in South Africa. “The waiting lists are growing by the day, risking that patients die before they start ARVs.”

He told delegates that it was “unbelievable that a relatively well-functioning ARV programme has been allowed to be crippled in the space of just a few weeks”.

In Rwanda however, the medical supplies agency CAMERWA said stocks were sufficient. There have not been any indications from any of the major funding partners of plans to scale back their support, according to Ambassador Zephyr Mutanguha, the CAMERWA Director-General.