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Delay nevirapine therapy after single doses during labor and delivery

KEY POINT

Compared with patients given placebo, women receiving single-dose nevirapine (Viramune—Boehringer Ingelheim) during labor and delivery to prevent perinatal transmission of HIV-1 were more likely to experience virologic failure if subsequently prescribed a nevirapine-based regimen within 6 months of labor. In these patients, delaying the use of a nevirapine for 6 months may improve outcomes.

SOURCES

Lockman S et al. Response to antiretroviral therapy after a single, peripartum dose of nevirapine. N Engl J Med. 2007;356:135–47.

Jourdain G et al. Intrapartum exposure to nevirapine and subsequent maternal responses to nevirapine-based antiretroviral therapy. N Engl J Med. 2004;351:229–40.

Coovadia H. Antiretroviral agents: how best to protect infants from HIV and save their mothers from AIDS. N Engl J Med. 2004;351:289–91.

Shapiro RL et al. Maternal single-dose nevirapine versus placebo as part of an antiretroviral strategy to prevent mother-to-child HIV transmission in Botswana. AIDS. 2006;20:1281–8.

Harvard School of Public Health. News release: six-month delay in use of nevirapine-based AIDS treatment can improve outcomes among postpartum mothers. 2007.

McIntyre JA et al. Addition of short course Combivir to single dose Viramune for the prevention of mother to child transmission of HIV-1 can significantly decrease the subsequent development of maternal and paediatric NNRTI-resistant virus. Presented at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment. July 24–27, 2005. Rio de Janeiro, Brazil.