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January 31, 2008

HIV Activists Fault South African Mother-Child Transmission Guidelines

In response to new South African treatment guidelines for the prevention of mother–child HIV transmission, the Treatment Action Campaign (TAC), an HIV/AIDS lobby group, has said that although the guidelines contain improvements, they fall short of World Health Organization recommendations, according to the South African financial daily newspaper Business Day/ (, 1/31).

The guidelines were issued on January 25. They advise that all HIV-positive pregnant women be treated with two HIV drugs: AZT from the 28th week of pregnancy, and nevirapine during labor. Infants of HIV-positive mothers are recommended to receive a dose of nevirapine syrup and seven days of AZT. The guidelines also recommend that all pregnant women be tested for HIV and that all babies of HIV-positive mothers be screened for the virus at 6 weeks and 18 months.

The new guidelines do not, however, change the threshold for when expectant mothers should start long-term therapy. They say that mothers should be treated when their CD4 count falls below 200, as opposed to 350, the level that many AIDS activists are calling for.

The TAC said that post-delivery, HIV-positive women should be given a week of AZT and lamivudine, known as the “cover-the-tail strategy,” in order to decrease nevirapine resistance. It also expressed disappoint at the decision not to change the threshold for initiating antiretroviral therapy.

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