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Short Course of Nevirapine Does Not Cut Eventual HIV Transmission via Breastfeeding
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Abstract
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| A new report suggests that while a six-week course of nevirapine may reduce the immediate risk of HIV transmission to babies breastfed by infected mothers, it does not significantly affect the risk of transmission at six months.
The results were based on studies from Ethiopia, India, and Uganda. The subjects of the research were 2,024 liveborn infants, all of whom received nevirapine 2 mg/kg after birth. The infants were then randomized to receive 5 mg of nevirapine daily for six weeks (case subjects) or no additional nevirapine (controls). All the mothers received 200 mg of nevirapine during labor. All the infants were uninfected at birth.
Six weeks after birth, 25 babies who received the extended therapy were HIV-positive, as were 54 babies who did not (odds ratio, 0.54, p=0.009). At six months, 62 extended therapy babies were HIV-positive, compared to 87 control babies; however, the difference between the two groups was no longer statistically significant. About one-third of the infants in each group had a grade 3 or 4 adverse event.
“Although a six-week regimen of daily nevirapine might be associated with a reduction in the risk of HIV transmission at six weeks of age, the lack of a significant reduction in the primary endpoint, risk of HIV transmission at six 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 feeding is not yet available and where the risks of replacement feeding are high,” the authors concluded.
The full report, “Extended-Dose Nevirapine to Six Weeks of Age for Infants to Prevent HIV Transmission via Breastfeeding in Ethiopia, India and Uganda: An Analysis of Three Randomized Controlled Trials,” was published in The Lancet (2008;372(9635):300-313).
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Source
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| http://www.reutershealth.com |
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Subjects
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Antiretroviral Drugs
Breastfeeding
HIV/AIDS Prevention
Mothers with HIV/AIDS
Perinatal Transmission
Studies or Surveys
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cdcnpin.org News Record #51384
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