Just one 75c dose can save a baby

A single dose of Nevirapine given to a baby as soon as possible after birth drastically reduces the chances of the child becoming HIV-infected.

This groundbreaking research carried out by Dr Glenda Gray of the HIV Perinatal Research Unit at Chris Hani Baragwanath will have profound implications for the prevention of transmission of the disease from mother to child.

Without any anti-retorviral drugs and with prolonged breastfeeding, 42 babies in 100 born to HIV-positive mothers get the disease.

Research has already shown that a single dose of Nevirapine given to a mother during labour, and to her child within 72 hours of birth, halved the rate at which mothers transmitted HIV to their babies - lowering the infection rate to 13 out of 100 children becoming infected.

But Gray's research now shows that should the mother not get anti-AIDS drugs before giving birth and if her baby receives only a single dose of Nevirapine, the rate of transmission is almost as low, with only 14 out of 100 becoming infected.

One of the implications of the research is that it will be affordable in developing countries - the cost of the treatment is just 75c compared to R400 for the six-week AZT course previously prescribed to the baby should the mother not have received treatment during delivery.

On Monday ,those trial results were to be presented to the world by South African scientists when the 14th International AIDS Conference gets under way in Barcelona.

Gray believes this is because Nevirapine is taken up by the baby more quickly, preventing transmission during the first few crucial days when most infection via breastmilk occurs.

"Nurses and doctors were always asking us what they could do for babies whose mothers didn't get Nevirapine during labour," she said.

"When these babies were put on the six-week course of AZT, the mother went home with a big bottle with the drug's name on it. It was only a matter of time before disclosure took place. But with Nevirapine, it's a single dose."

Gray hopes to do further research, comparing the transmission rate in babies whose mothers also receive Nevirapine during labour with those whose mothers don't.

If, as appears to be the case, both are equally effective, babies could, in future, be the only maternity ward patients taking Nevirapine. This would go a long way towards allaying fears about the drug-resistant HIV strains which emerge temporarily in a quarter of the mothers who take the pill during labour.

For one mother, the trial was a lifesaver for her child.

She now has a healthy baby boy. She was present when nurses gave him a few drops of the liquid as part of the study. "He didn't like the taste. He cried," she said.

And she knows that it probably saved her baby's life.