Inexpensive HIV treatment tested for poor nations

ATLANTA (AP) — The rate of mother-to-child AIDS transmission was cut in half in Thailand by treating HIV-infected mothers with the drug AZT for less than a month, U.S. health officials said Wednesday.
The treatment — which costs only $80, compared with $800 for the 26-week treatment used in the Western world — offers hope for developing countries where most of the world’s HIV-infected babies are born.
The study in Thailand, which included 391 women, found that 9 percent of those given AZT near the end of their pregnancy passed HIV on to their babies, compared with 19 percent of those given dummy pills.
Critics of the U.S. government studies in Thailand and other poor nations say the use of dummy pills for some participants unethically withholds AIDS drugs from some women. The CDC has argued that the studies are essential to find alternative therapies for countries that can’t afford costlier treatments.
“Until now, the only regimen proven effective for perinatal HIV prevention was essentially out of reach for the countries in which over 90 percent of HIV infections occur,” said Dr. Helene D. Gayle, director of the Centers for Disease Control and Prevention’s National Center for HIV, STD and TB Prevention.
The Thai women were given AZT for three to four weeks at the end of their pregnancy, plus an oral dose during delivery. Their infants, who were not given any of the drug, were tested for the HIV virus at birth and at two months.
The treatment widely used in the United States calls for 26 weeks of AZT treatments, an intravenous dose of AZT during delivery and six weeks of treatments for the infant. It has been shown to reduce HIV transmission by 67 percent.
In the developing world, where the annual health budget is as low as $10 per person, the cost of such a treatment is prohibitive. The longer treatment also relies on women pursuing early prenatal care, which is infrequent in the developing world.
Public Citizen, an advocacy group that has criticized the studies, has been arguing since last year that shorter AZT treatment should be compared with longer treatment, instead of using dummy pills.
“The tragedy is that precious time and money have been wasted, dozens of infants in the CDC trial are now unnecessarily HIV-positive and we still aren’t sure if shorter regimens are as good as longer ones,” said Dr. Peter Lurie, a Public Citizen research associate.
Thrilled with the Thailand study’s results, the CDC has halted a similar study in Abidjan, Ivory Coast, and has given all the women in that study the shorter course of AZT, Gayle said.
“Given the fact that we have shown that a short course is safe and effective, a study to prove the same thing would not be appropriate,” she said.