A national, multicenter study has found that HIV-infected women who used illicit drugs during pregnancy had a higher risk of transmitting HIV to their infants than did HIV-infected women who did not use drugs while pregnant.
The study, known as the Women and Infants Transmission Study (WITS), was launched in 1989 by the National Institute of Allergy and Infectious Diseases (NIAID) to track the natural history of HIV in infected women and their infants. The study currently is funded by NIAID, NIDA, and the National Institute of Child Health and Human Development.
In the study, researchers analyzed data on 530 HIV-infected pregnant women and their infants who were treated in obstetric and pediatric clinics in five cities across the United States. The analysis showed that the HIV perinatal transmission rate for women who used drugs during pregnancy was 27 percent compared with a 16 percent transmission rate among HIV-infected women who did not use drugs. Forty-two percent of the women in the study used illicit drugs during pregnancy; 44 percent of those women used multiple drugs. The most commonly used drug was cocaine, used either alone or in combination with other drugs.
The study's findings emphasize the critical role of drug abuse treatment in prenatal health care for HIV-infected pregnant women who use drugs, according to Dr. Evelyn M. Rodriguez of the Health Resources Services Administration and her colleagues in the WITS. The WITS findings also underscore the importance of ensuring that all HIV-infected women receive information on how AZT (zidovudine) treatment during pregnancy can significantly reduce perinatal transmission of HIV, the researchers conclude.
Large multisite studies such as the WITS enable researchers to investigate both the behavioral and basic biological factors that may contribute to maternal-infant transmission of HIV, according to Dr. Vincent Smeriglio and Katherine Davenny of NIDA's Division of Clinical and Services Research, who are members of the WITS research staff. Further research is planned to verify the association between maternal drug use and infant HIV infection and to clarify the possible mechanisms of this association, they indicate.
Source
- Rodriguez, E.M.; Mofenson, L.M.; Chang, B.H.; Rich, K.C.; Fowler, M.G.; Smeriglio, V.; Landesman, S.; Fox, H.E.; Diaz, C.; Green, K.; and Hanson, I.C. Association of maternal drug use during pregnancy with maternal HIV culture positivity and perinatal HIV transmission. AIDS 10(3):273-282, 1996.