To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Extended-Dose Nevirapine May Reduce Risk of Mother-to-Infant HIV Transmission in Developing Countries URL: http://www.pslgroup.com/dg/226446.htm Doctor's Guide July 24, 2008
NEW YORK -- July 24, 2008 -- A regimen of extended-dose nevirapine could reduce the risk of infants contracting the HIV virus from their HIV-infected mothers, according to a study in this week's HIV special issue of The Lancet. A long course of such treatment could be effective where access to affordable and safe replacement feeding is not yet available. Robert Bollinger, MD, Johns Hopkins Center for Clinical Global Health Education, Bethesda, Maryland, and colleagues conducted 3 randomised trials in Ethiopia, India, and Uganda to assess whether nevirapine given daily to breastfed infants up to 6 weeks of age could decrease HIV transmission via breastfeeding. HIV-infected, breastfeeding mothers were randomised to receive either nevirapine 200 mg in labour and nevirapine 2 mg/kg to newborns after birth (single-dose nevirapine [SDN]) or a 6-week extended dose of nevirapine (EDN) -- same as with SDN plus nevirapine 5 mg QD from days 8 to 42 for the infant. The primary endpoint was HIV infection in infants aged 6 months who had tested HIV-negative at birth. The analysis included 986 SDN infants and 901 EDN infants. At 6 months, 87 children in the SDN group were HIV-positive compared with 62 in the EDN group -- a 20% reduced risk of becoming HIV-positive for infants in the EDN group. This finding was not statistically significant. However, at 6 weeks, 54 infants in the SDN group and 25 infants in the EDN group were HIV-positive, which meant a reduced risk of 46% of contracting HIV for EDN infants. "Although a 6-week regimen of daily nevirapine might be associated with a reduction in the risk of HIV transmission at 6 weeks of age, the lack of a significant reduction in the primary endpoint -- risk of HIV transmission at 6 months -- suggests that a longer course of daily infant nevirapine to prevent HIV transmission via breast milk might be more effective where access to affordable and safe replacement feedings is not yet available and where the risks of replacement feeding are high," the authors wrote. In an accompanying comment, Jeffrey Stringer, MD, and Benjamin Chi, MD, University of Alabama, Birmingham, Alabama, working from The Centre for Infectious Disease Research, Lusaka, Zambia, said, "Extended infant prophylaxis with nevirapine is simple enough to be implemented almost anywhere. It represents a long-awaited, if partial, solution to a mother's impossible choice. We should not delay." SOURCE: The Lancet --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.