Effect of nevirapine toxicity on choice of perinatal HIV prevention strategies.
OBJECTIVE
This study evaluated the validity of concerns about the toxicity of nevirapine (NVP) that have delayed its implementation as a perinatal HIV prevention strategy.


METHODS
A decision analysis model compared 3 strategies: single-dose NVP, short-course zidovudine (ZDV), and no intervention.


RESULTS
NVP would prevent more deaths than ZDV and no intervention as long as the rate of NVP toxicity did not exceed, respectively, 9 times that observed in the earlier NVP clinical trial and 42 times that observed in the clinical trial. NVP would be economically preferable to ZDV as long as the rate of toxicity did not exceed 22 times that observed in the clinical trial.


CONCLUSIONS
Field implementation of NVP should not be delayed by concerns about its toxicity.
Stringer
Jeffrey S A
JS
Center for Research in Women's Health, University of Alabama at Birmingham, Birmingham, AL, USA. stringer@uab.edu
Sinkala
Moses
M
Rouse
Dwight J
DJ
Goldenberg
Robert L
RL
Vermund
Sten H
SH
D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D015331:Cohort Studies; D003661:Decision Support Techniques; D005260:Female; D005313:Fetal Death / Q000139:chemically induced; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D018743:Perinatal Care / Q000191:economics*; D011247:Pregnancy; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D015215:Zidovudine / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics
D019380:Anti-HIV Agents; D015215:Zidovudine; D019829:Nevirapine