A French government agency has released preliminary results of a study that shows
70 percent of babies born to HIV-positive mothers in Cambodia avoided contracting
the virus after both were given the drug nevirapine.
Dr Philippe Glaziou, an AIDS researcher at Phnom Penh's Pasteur Institute, said he
considered the pilot project a success. The final results are due at the end of the
year.
"The feasibility study was to test whether it is acceptable to implement the
mother-to-child transmission strategy," said Dr Glaziou. "It is a simple
test which involves giving one dose to the mother and another to the newborn child."
The agency, ANRS, operates AIDS research programs in developing countries in Southeast
Asia, Africa and Latin America. It opened its Cambodia office in July 2000.
The program tested more than 2,000 pregnant women for HIV infection. It found 114
had the virus, and they were given the drug free during hospitalization and when
giving birth at the city's Calmette Hospital.
Of the 78 newborn babies included in the preliminary study, testing at the Pasteur
Institute showed only six were infected with HIV. A press release from ANRS stated
that women with HIV run a high risk of passing it on during childbirth.
Nevirapine has been proven successful in reducing the transmission of HIV in other
countries, but this is the first time a study has been undertaken in Cambodia.
However, the economic position of most Cambodian women means the benefits of nevirapine
could be undermined as the virus can be transmitted through breast milk, which is
normally far better than milk substitutes.
ANRS informed the 78 new mothers that the virus could be transmitted through breast-feeding.
Dr Glaziou said 90 percent then opted to bottle-feed their babies, although the rest
still chose to breast-feed their children despite the risks.
"This 10 percent chose breast-feeding as they are too poor to buy milk,"
he said. "Also they keep the knowledge about HIV to themselves as it might show
there is something wrong in their families."
Dr Koum Kanal, the director of National Maternal and Child Health Center, said most
mothers could not afford milk powder, which costs around $70 a month.
Additionally, he said, if every Cambodian mother bottle-fed their children, there
would be more baby deaths than those caused by breast milk from infected mothers.
"Bottle-feeding provides good nutrition," he said, "but can kill the
babies if their mothers do not know how to use it. Some don't even know they need
to mix it with water."
Kanal said a June meeting in Beijing discussed the issue of mothers transmitting
the virus through breast milk. Of the countries attending, Cambodia, China, India
and Myanmar all chose to promote breast-feeding.
"In Thailand the government gives one year's supply for the babies, but here
we have no money to buy milk," he said. "Will we allow those babies to
die from bottle-feeding or from AIDS? Most mothers can't find enough money to buy
food for themselves."
Srey Rath, 19, was one of those in the ANRS program. Her husband died from AIDS last
year, two years after her first child whose death was also likely due to AIDS.
Her 4-month old baby is still free of the virus after she followed a doctor's advice
about bottle-feeding. She was grateful to an NGO for providing powdered milk she
would otherwise be unable to afford.
To make ends meet Rath works every day peeling vegetables, starting at 2 a.m. and
finishing at 9 a.m. For that she earns 4,000 riel ($1), sufficient only to support
her family and pay her room rent.
"I thought I would transmit the virus to my baby, but the doctor told me she
would be fine," Rath said. "But I am very worried since my baby now drinks
a lot of milk and I have no money."
