Use of combination therapy rather than AZT monotherapy cut the rate of intrapartum HIV transmission in half.
Infant postexposure prophylaxis with a multidrug antiretroviral (ARV) regimen has been shown to reduce perinatal transmission in breastfed infants whose mothers presented late for delivery with unknown HIV status (JW Infect Dis Jun 16 2010 and Aug 23 2004). However, until this study, the superiority of combination ARVs over AZT monotherapy for formula-fed infants was unproven.
From 2004 to 2010, 1684 infants born to mothers who had not received ARV prophylaxis during pregnancy were randomized to start one of three prophylaxis regimens within 48 hours of birth: AZT alone for 6 weeks, AZT for 6 weeks plus three doses of nevirapine during the first 8 days of life (2-drug group), or AZT for 6 weeks plus 2 weeks of 3TC and nelfinavir (3-drug grou…