Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: Clinical trial in Mombasa, Kenya

Philippe Gaillard, Fabian Mwanyumba, Chris Verhofstede, Patricia Claeys, Varsha Chohan, Els Goetghebeur, Kishorchandra Mandaliya, Jeckoniah Ndinya-Achola, Marleen Temmerman

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68 Citations (Scopus)


Objectives: To evaluate the effect of vaginal lavage with diluted chlorhexidine on mother-to child transmission of HIV (MTCT) in a breastfeeding population. Methods: This prospective clinical trial was conducted in a governmental hospital in Mombasa, Kenya. On alternating weeks, women were allocated to non-intervention or to intervention consisting of vaginal lavage with 120 ml 0.2% chlorhexidine, later increased to 0.4%, repeated every 3 h from admission to delivery. Infants were tested for HIV by DNA polymerase chain reaction within 48 h and at 6 and 14 weeks of life. Results: Enrolment and follow-up data were available for 297 and 309 HIV-positive women, respectively, in the non-lavage and the lavage groups. There was no evidence of a difference in intrapartum MTCT (17.2 versus 15.9%, OR 0.9, 95% Cl 0.6-1.4) between the groups. Lavage solely before rupture of the membranes tended towards lower MTCT with chlorhexidine 0.2% (OR 0.6, 95% Cl 0.3-1.1), and even more with chlorhexidine 0.4% (OR 0.1, 95% Cl 0.0-0.9). Conclusion: The need remains for interventions reducing MTCT without HIV testing, often unavailable in countries with a high prevalence of HIV. Vaginal lavage with diluted chlorhexidine during delivery did not show a global effect on MTCT in our study. However, the data suggest that lavage before the membranes are ruptured might be associated with a reduction of MTCT, especially with higher concentrations of chlorhexidine.

Original languageEnglish
Pages (from-to)389-396
Number of pages8
Issue number3
Publication statusPublished - 16 Feb 2001
Externally publishedYes


  • Chlorhexidine/administration and dosage
  • Cohort studies
  • HIV infections
  • Mother-to-child transmission
  • Newborn infant


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