Oral alternatives to intravenous zidovudine during labor for the prevention of vertical transmission of HIV
Keywords:
Oral Zidovudine, Vertical Transmission, Labor, HIVAbstract
The use of IntraVenous Zidovudine (IV AZT) during labor for the prevention of HIV vertical transmission is widely documented, with specific indications on the cases in which it should be administered.In several countries IV AZT is not available. In our country in recent years there have been recurrent shortages in the market and for prolonged periods.This scarcity situation led us to search for and analyze an alternative intrapartum dosage regimen which could provide a similar protection to that obtained with IV AZT in order to carry out an emergency protocol for situations of shortages.We have carried out a systematic bibliographic search of the last 25 years in Medline-PubMed and Cochrane. Search strategy: keywords: Zidovudine, Oral, HIV, Intrapartum, Labor; and we have also reviewed the Clinical Practice Guidelines (CPG) of Latinamerican countries (LATAM).A total of 373 articles and 16 CPG were found. In the first selection by title and/or abstract, 349 were eliminated. After applying the inclusion/exclusion criteria, 6 articles were selected: 5 clinical trials and 1 systematic review with meta-analysis. We have found oral alternatives to replace the lack of IV AZT, in different dosage regimens, adopted by most LATAM countries and PAHO-WHO. It is necessary to include an alternative dosage regimen in our national recommendations so that in the situation of not having IV AZT available, it can be replaced by oral administration and thus leaving patients without medication can be avoided.
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