Use of single-dose nevirapine for the prevention of mother-to-child transmission of HIV-1: does development of resistance matter?

Am J Obstet Gynecol. 2007 Sep;197(3 Suppl):S56-63. doi: 10.1016/j.ajog.2007.02.031.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Drug Resistance
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / transmission*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Nevirapine / administration & dosage*
  • Nevirapine / therapeutic use
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents
  • Nevirapine