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OB: Antibiotics May Decrease Perinatal HIV TransmissionFrom: art fougner, md (evsono@pipeline.com)Fri Dec 11 06:45:35 1998
Hot off the Presses - excerpted in ReautersHealth News - Antibiotics may reduce vertical HIV transmission rates WESTPORT, Dec 11 (Reuters Health) - Administration of antibiotics to HIV-positive women during pregnancy may be an inexpensive means of reducing the rate of vertical HIV transmission, researchers suggest in the December 12th issue of The Lancet. "We postulate that important components of perinatal transmission of HIV-1 include both preterm chronic chorioamnionitis and acute chorioamnionitis at term," Dr. Robert L. Goldenberg and colleagues at the University of Alabama at Birmingham explain. "We also believe that a portion of this chorioamnionitis could be prevented in its early stages with metronidazole alone or with other antibiotics." They hypothesize that, because intrauterine bacterial infection increases the levels of amniotic fluid cytokines, this leads to the migration of HIV-infected leukocytes into the amniotic cavity. When antibiotic treatment should be initiated and which patients should be treated is not clear, they add. Dr. Goldenberg's team suggests that HIV-positive women presenting with rupture of membranes prior to labor, women with risk factors for chorioamnionitis and those with slow progression of labor may be good candidates for antibiotic treatment. Antibiotics and microbicide treatments added to antiretroviral regimens may result in small benefits for HIV-positive pregnant women in developed countries. The real potential value would be for women in developing countries, were antiretroviral treatment is unavailable, they point out. Dr. Goldenberg's team estimates that in countries of sub-Saharan Africa, the total cost of antibiotic treatment would be $10.00 per woman, and the cost of microbicide treatment would be even less. They also suggest that the use of antibiotics to reduce chorioamnionitis associated with HIV transmission may "nicely complement" short-course antiretroviral regimens. Lancet 1998;352:1927-1930. -Westport Newsroom 203 319 2700 Happy and Blessed Holidays! Art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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