Inclusion Criteria

Concurrent Medication:

Allowed:

• In one group of four or more patients, methadone maintenance treatment.
• Acetaminophen for periods less than 72 hours.
• Supportive therapy including blood and blood products, vaginal creams, antiemetics, antidiarrheals, and cough medicines as deemed necessary by the responsible investigator.
• Iron, multivitamins, and short course of treatment for correctable medical problems, such as urinary tract infection.

Concurrent Treatment:

Allowed:

• Blood and blood products as supportive therapy.

Patients must have HIV-1 infection and be in the third trimester of pregnancy. Additional patients will also be receiving methadone maintenance therapy for intravenous drug use.

Exclusion Criteria

Concurrent Medication:

Excluded:

• Systemic medications during this pregnancy.
• Acetaminophen for periods more than 72 hours.

Patients will be excluded from the study for the following reasons:

• Complications of pregnancy.
• History of poor medical compliance related to factors other than accessibility of care.
• Insistence on breast-feeding during the first 24 hours of the birth of the child.
• Evidence of preexisting fetal anomalies at = or > 20 weeks gestation as noted by an abnormal level 2 sonogram prior to study entry.
• Evidence of fetal intolerance of the intrauterine environment including intrauterine growth retardation, oligohydramnios, polyhydramnios, biophysical profile equal to or less than 6 for fetus with a gestational age > 32 weeks, congenital malformation, fetal hydrous or ascites.
• Previous systemic infection including influenza during this pregnancy.
• Malabsorption syndrome and/or history of frequent diarrhea that might interfere with absorption of oral zidovudine (AZT).

Prior Medication:

Excluded:

• Antivirals and other systemic medications during this pregnancy.

Patients may not have any of the following diseases or symptoms:

• Obstetrical complications:
• Poor obstetrical history including but not limited to recurrent spontaneous abortions, previous preterm or low-birth-weight infant, congenital anomalies (past or present pregnancy), premature rupture of membranes, multiple gestation, intrauterine fetal death (this pregnancy), and placenta previa or abruptio (this pregnancy).
• Medical complications:
• Conditions including but not limited to insulin-dependent diabetes mellitus (IDDM), hypertensive disorders which include preeclampsia, eclampsia, chronic hypertension, cardiovascular disease including rheumatic or congenital heart disease, collagen vascular disease, endocarditis, and renal disease.
• Hematologic complications.
• Neurologic complications.
• Pulmonary complications.

History of illicit drug use during this pregnancy.

• Note: This exclusion applies only to the first six or more women to enter this study who do not have a history of intravenous drug use.

Four or more patients:

• Intravenous drug use, if enrolled in a methadone maintenance program.