New Moms Should Avoid Nevirapine

March 11, 2010

Women with the human immunodeficiency virus (HIV) who become pregnant are treated with the HIV prevention drug known as nevirapine. This medication serves to protect the fetus. However, research performed by scientists at the University of Alabama, at Birmingham (UAB) suggests that women should not use an HIV-drug regimen containing nevirapine for at least a year after they deliver.

Prevent Transmission

The study says that while nevirapine does a great job of preventing the transmission of HIV from mother to child, even a single dose in pregnancy administered to an infected woman can set up a resistance to some formulations of the AIDS drug cocktail that is known as combination antiretroviral treatment (ART).  However, this resistance to nevirapine starts to wear off after about a year and then no longer poses a problem for women who need to be treated with the drug cocktail. This is according to Jeffrey S.A. Stringer, M.D., lead author of the study and a University of Alabama Professor of Obstetrics and Gynecology.

Nevirapine, given as a single dose, is in wide use for the prevention of mother-to-child transmission of HIV. The virus is contracted by over 30 million worldwide and is a contributory factor for the over 2 million deaths from AIDS each year. "This study shows that women who need treatment more than 12 months after using nevirapine to prevent mother-to-child transmission safely can use standard first-line treatments in their countries," says Stringer, who directs Center for Infectious Disease Research in Zambia which is affiliated with the Birmingham, Alabama university. "Women who need treatment sooner than that should use a combination that does not contain nevirapine, typically an ART regimen that contains protease-inhibitor drugs."

Single Dose

A total of 878 women with HIV from Thailand, Cote d'Ivoire, and Zambia, were treated with a single dose of nevirapine while others were not given the treatment. Both groups were administered ART as soon as their infection was confirmed. The women were monitored over the course of a year.

Nevirapine is still the mainstay of anti-HIV therapy in third world countries. Stringer says that the new study supports the view that the drug is helpful in preventing transmission of the virus from mother to child.

The study was a collaboration between many partners, including the UAB; the United States Centers for Disease Control and Prevention's (CDC) Division of HIV/AIDS Prevention and Global AIDS Program; the Lusaka, Zambia-based Centers for Infectious Disease Research; the Catholic Medical Missions Boards; the Urban District Health Management Board in Lusaka; the University of Nairobi, the Bangkok-based Rajavithi Hospital; the Ministry of Public Health in Thailand, and the Northrop Grumman Corp. The funding for this study was provided by the CDC and the study findings were published in PLoS Medicine.

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