Feature story

‘A better future’: New evidence shows triple antiretroviral drugs during pregnancy and breastfeeding can significantly reduce mother-to-child transmission of HIV

14 January 2011

Credit: UNAIDS/P. Virot

The Lancet Infectious Diseases today published evidence from a World Health Organization-led study. The study showed that giving pregnant women living with HIV a combination of three antiretroviral (ARV) drugs from the last trimester, through delivery and six months of breastfeeding can reduce the risk of their babies being infected with HIV by more than 40%.

The study, named Kesho Bora which means ‘a better future’ in Swahili, was conducted between June 2005 and August 2008 in five sites in Burkina Faso, Kenya and South Africa. The randomized controlled trial aimed to assess the efficacy and safety of triple antiretroviral treatment to reduce mother-to-child transmission of HIV. This was compared to the use of single-dose nevirapine and zidovudine stopped after delivery, as had been recommended by the World Health Organization (WHO) since 2004.

Triple antiretroviral treatment given to pregnant women with a CD4 immune cell count of 200-500 cells/mm3 starting in their last trimester reduced mother-to-child transmission by 43% and reduced the risk of infection during breast-feeding by more than half. It was also shown to be safe for both mother and baby.

The WHO’s Department of Reproductive Health and Research worked in partnership on the study with the French National Agency for Research on AIDS and Viral Hepatitis (ANRS), the US Centers for Disease Control and Prevention (CDC) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health.