AN INTERVENTION TO REDUCE THE RISK OF MOTHER-TO-INFANT HIV TRANSMISSION - RESULTS OF A PILOT TOXICITY STUDY

Although unproven, vaginal cleansing with antiseptics during labour co uld be a practical approach to reducing the rate of transmission of HI V infection from mother to infant. Before initiating a large scale cli nical trial of the antiseptic chlorhexidine, we conducted a study to a ssess possible toxic effects as well as beneficial outcomes in 160 wom en volunteers: 40 non-pregnant chlorhexidine washed, 40 pregnant not w ashed, 40 pregnant saline washed, and 40 pregnant chlorhexidine washed . The wash was easily administered by the nurse-midwives. The particip ants generally felt better after the procedure, and had no complaints or adverse reactions in the subsequent 24 hours. Bacteriologically, th e procedures lowered the carriage of Group B streptococcus and Staphyl ococcus aureus, but did not affect the frequency of T. vaginalis detec tion. No clinical problems were seen, and therefore the larger clinica l trial of efficacy will proceed. Results of this trial are expected i n late 1995.