Strategie terapeutiche antiretrovirali per il contenimento del rischio di trasmissione dell'infezione da HIV per via verticale

Objectives: To evaluate the efficacy and tolerance of different protocols of antiretroviral therapy in HIV-infected pregnant women. Patients and methods: From 1994 to 1997 44 HIV-infected pregnant women were followed in the Institute of Infectious Diseases of Pavia. 22 of them were treated with AZT only, while 3 received two nucleoside inhibitors of reverse transcriptase with or without one protease inhibitor. AZT was also administered to 19 newborns during the first 4-6 weeks of life. Results: The most common adverse effect of antiretroviral therapy was mild anaemia, occurring in 18% of women. Only one patient, treated with AZT monotherapy, transmitted the HIV infection to her newborn. Conclusions: More and more frequently the HIV pregnant women will need to begin or to continue the combination antiretroviral therapy with drugs different than AZT. The need of clear guidelines relating to the most appropriate approach in pregnancy and subsequent management of the newborn and of the mother is highlighted.