Use of single-dose nevirapine for the prevention of mother-to-child transmission of HIV-1: does development of resistance matter?
Nevirapine resistance has been detected in a considerable proportion of women after single-dose nevirapine (SD-NVP) for the prevention of mother-to-child human immunodeficiency virus-1 transmission. As a result, concern has been raised about the effectiveness of subsequent nevirapine-based treatment. Studies in Thailand, Botswana, and South Africa have assessed virologic treatment response after SD-NVP. These studies did not find any significant difference in virologic response for women who began treatment >6 months after SD-NVP exposure. Two studies found worse response rates in women when treatment was initiated within 6 months of SD-NVP exposure. Furthermore, 2 studies found no difference in human immunodeficiency virus transmission rates from mother to child after the receipt of SD-NVP in repeat pregnancies. These data support the use of SD-NVP as 1 option for the prevention of mother-to-child human immunodeficiency virus-1 transmission in resource-limited settings, particularly in settings where more complex regimens are not yet available. Further research in the optimization of perinatal prevention regimens is needed.
McConnell
Michelle S
MS
Thailand-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. zmd8@cdc.gov
Stringer
Jeffrey S A
JS
Kourtis
Athena P
AP
Weidle
Paul J
PJ
Eshleman
Susan H
SH
D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D004351:Drug Resistance; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage* / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*