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Western Cape works towards elimination of paediatric HIV/AIDS
Di Caelers. 26 May 2003. Cape Argus. Republished courtesy of Independent Newspapers (Pty) Ltd.
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The Western Cape is set to take a giant step towards eliminating paediatric HIV/AIDS, with plans to add an extra drug to its strategy to prevent mother-to-child HIV transmission.
In other parts of the world, similar treatment regimes have shown mother-to-child transmission has been reduced to four percent, a more than 10-fold improvement on the outcome of the single Nevirapine dose to mother and baby currently available in the province.
Under the new treatment plan, likely to be available in two months, HIV-positive pregnant women will get the single dose of Nevirapine, but a six-week course of the drug AZT will be added, says the head of HIV/AIDS in the province, Dr Fareed Abdullah.
Abdullah, disclosing the news, said there was already 100 percent coverage of the province under the current plan.
Although they had not decided finally on whether the new regimen would include two or three drugs, it would include a CD4 count test - which measures the body's ability to fight HIV - for every eligible woman.
"We are likely to go with two drugs because we have learned that there is not a very big difference in outcome whether you go for the two-drug or three-drug option.
"The real concern lies with the small group of women who have Stage 3 or Stage 4 AIDS, or advanced disease, who are the high transmitters.
These women must get three drugs," said Abdullah.
The CD4 test would pick out these women, and the remainder would go on the two-drug treatment: one dose of Nevirapine and six weeks of AZT.
With the single dose of nevirapine, the chances of women passing on HIV to their babies is halved.
But Abdullah said his team had been advised by French doctor François Dabis, who had tested the two-drug treatment in Ivory Coast, reducing transmission rates there to just seven percent.
Explaining the need for the switch, Abdullah said that triple-therapy treatment for all pregnant women with HIV was now firmly on the cards for South Africa, raising potential problems with resistance in terms of women given the single-drug therapy.
The extra cost will be borne by the province, and has already been factored into this year's budget.
The new treatment was likely to start in July or August in the metro area. |
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