title: Efavirenz-based antiretroviral therapy versus nevirapine-including regimens for prevention of mother-to-child transmission of HIV option B plus in resource-limited settings: is there anything missing?
abstract: In 2013, an estimated 1.5 million HIV-positive pregnant women gave birth, with 240,000 children worldwide acquiring HIV. More than 90% of new pediatric infections occurred in Sub-Saharan Africa. The latest WHO guidelines recommended efavirenz (EFV)-based antiretroviral therapy as the first-line regimen for prevention of mother-to-child transmission of HIV (PMTCT). On the other hand, some data suggest that nevirapine (NVP), a well-known antiretroviral, could still play a relevant role in PMTCT, especially in resource-limited settings (RLSs) where the fertility rate is dramatically high compared to developed countries. Given the lack of an unanimous consensus and definitive opinions, this paper goes through the reasons for WHO decisions and aims at refreshing the debate about NVP and EFV pros and cons for PMTCT in RLSs.
authors.affiliation: a Resource Centre for Infectious Diseases , Clinical Department, Dodoma Regional Referral Hospital , Dodoma , Tanzania.|b National Institute for Infectious Diseases "Lazzaro Spallanzani" , Rome , Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Nardo
authors.affiliation: a Resource Centre for Infectious Diseases , Clinical Department, Dodoma Regional Referral Hospital , Dodoma , Tanzania.|c Department of Infectious Diseases , University Hospital Tor Vergata , Rome , Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Gentilotti
authors.affiliation: a Resource Centre for Infectious Diseases , Clinical Department, Dodoma Regional Referral Hospital , Dodoma , Tanzania.|b National Institute for Infectious Diseases "Lazzaro Spallanzani" , Rome , Italy.
authors.forename: Boniface
authors.initials: B
authors.lastname: Nguhuni
authors.affiliation: b National Institute for Infectious Diseases "Lazzaro Spallanzani" , Rome , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vairo
authors.affiliation: a Resource Centre for Infectious Diseases , Clinical Department, Dodoma Regional Referral Hospital , Dodoma , Tanzania.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Chaula
authors.affiliation: b National Institute for Infectious Diseases "Lazzaro Spallanzani" , Rome , Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Nicastri
authors.affiliation: b National Institute for Infectious Diseases "Lazzaro Spallanzani" , Rome , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D000480:Alkynes; D048588:Benzoxazines / Q000191:economics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003521:Cyclopropanes; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics / Q000473:pathology / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000201:enzymology / Q000472:pathogenicity; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000191:economics / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics / Q000517:prevention & control*; D018894:Reverse Transcriptase Inhibitors / Q000191:economics / Q000627:therapeutic use*
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz
keywords: HIV; HIV-positive pregnant women; PMTCT; Sub-Saharan Africa; efavirenz; nevirapine; option B plus; resource-limited settings