Intrapartum transmission after mucosal exposure to HIV was not observed with single-dose nevirapine for mother and child.
BACKGROUND
Intrapartum transmission of HIV has been reported to be associated with HIV in oropharyngeal secretions (OPSs) of the child. In this study, we analyze the frequency of intrapartum transmission after mucosal exposure to HIV after administration of single-dose nevirapine.


METHODS
Eighty mothers and their children participating in a prevention of mother-to-child transmission of HIV program in Uganda who took a single dose of nevirapine according to the HIVNET012 protocol participated in the study. HIV-1 was quantified by polymerase chain reaction (PCR) in the mothers' and children's plasma, in cervicovaginal secretions (CVSs), and in the children's OPSs. Intrapartum transmission was defined as a positive HIV-1 RNA PCR result at week 1 or 2 after birth and a previously negative PCR result.


RESULTS
Ninety-seven percent of children had detectable nevirapine in their OPS (median = 592 ng/mL). Fifty-seven (81%) children had HIV-negative OPSs, and 13 (19%) had HIV-positive OPSs. All children of mothers with HIV-negative CVSs had HIV-negative OPSs. HIV-1 levels of OPSs and CVSs correlated (r = 0.33, P = 0.027). None of the babies with detectable HIV-1 in the OPSs became infected by means of intrapartum transmission.


CONCLUSIONS
Intrapartum HIV infection was not observed after mucosal exposure to HIV-1 after administration of a single dose of nevirapine to the mother and child.
Kunz
Andrea
A
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Spandauer Damm 130, 14050 Berlin, Germany.
Mugenyi
Kizito
K
Karcher
Heiko
H
Mayer
Angelika
A
Simo
Shirin
S
Ali
Moses
M
Kurowski
Michael
M
Harms
Gundel
G
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009092:Mucous Membrane / Q000821:virology; D019829:Nevirapine / Q000008:administration & dosage*; D009960:Oropharynx / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D014454:Uganda; D014621:Vagina / Q000821:virology
D019380:Anti-HIV Agents; D019829:Nevirapine