Efavirenz-based combination antiretroviral therapy after peripartum single-dose nevirapine

Int J STD AIDS. 2011 Jan;22(1):38-42. doi: 10.1258/ijsa.2010.010229.

Abstract

Single-dose nevirapine (sdNVP) reduces mother-to-child HIV transmission, but induces NVP resistance and subsequent NVP-based combination antiretroviral therapy (cART) may fail. Some resistance mutations affect NVP more than efavirenz (EFV). We evaluated virological suppression of EFV-based cART in women after sdNVP. A retrospective analysis matched 107 women who had received sdNVP within the 24 months before cART (cases) with women who had never received sdNVP (controls). By total cohort (intention-to-continue treatment) at week 96, 65% of cases and 73% of controls had a viral load (VL) <400 copies/mL and 63% of cases and 64% of controls had VL <25 copies/mL. At weeks 48 and 96, women starting cART less than six months after sdNVP (n = 20) had VL <400 copies/mL of 90% and 75%, respectively compared with 90% and 70%, respectively, for controls. Overall 172 (80%) women reached week 96. EFV-based cART, in field conditions, was effective for women after sdNVP, even within six months of sdNVP.

MeSH terms

  • Adult
  • Alkynes
  • Anti-HIV Agents / administration & dosage*
  • Antiretroviral Therapy, Highly Active / methods*
  • Benzoxazines / administration & dosage*
  • Cyclopropanes
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control
  • Middle Aged
  • Nevirapine / administration & dosage*
  • Peripartum Period
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Infectious / prevention & control
  • Retrospective Studies
  • Treatment Outcome
  • Viral Load

Substances

  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cyclopropanes
  • Nevirapine
  • efavirenz