07 November 2007

Combo beats nevirapine

Treatment with a combination of four drugs is more effective than just nevirapine in preventing mother-to-child transmission of HIV, researchers report.

Treatment with a combination of four drugs is more effective than just nevirapine in preventing mother-to-child transmission of HIV and reducing maternal niverapine resistance, researchers report.

A single dose of the drug nevirapine during labour reduces the chances of infants inheriting HIV by 40 percent.

But if the newborn still becomes infected despite the drug, the child is more likely to acquire a strain of the virus that is resistant to the medications most commonly used to treat HIV.

In a study, published in The Lancet medical journal, 199 of 397 HIV-infected pregnant women who sought care at two public sector health facilities in Lusaka, Zambia were given single doses of two other drugs - tenofovir and emtricitabine - along with the nevirapine during birth.

All three drugs are known as non-nucleoside reverse transcriptase inhibitor drugs, or NNRTIs.

A second group of 198 soon-to-be-mothers were given only the nevirapine, as has been standard practice.

Both groups also took a short course of a fourth drug, zidovudine, better known as AZT.

Lowers drug resistance
The researchers, led by Benjamin Chi of the Centre for Infectious Disease Research in Zambia and University of Birmingham in Alabama, found that women given the four-drug combo were 53 percent less likely to develop higher resistance to NNRTIs six weeks after delivery.

The absolute risk was cut in half: 12 percent for the test group, and 25 percent for the control group.

While some serious adverse events were reported - postpartum anaemia for mothers, and pneumonia for the infants - in both groups, none were judged to be caused by the new drug mixture.

These results "provide strong evidence that adding single-dose tenofovir/emtricitabine" to standard treatments "is a new, effective, and feasible approach to reducing maternal nevirapine resistance," noted Shahin Lockman and James McIntrye of the Harvard School of Public Health in Boston in a comment, also published in The Lancet. – (Sapa-AFP)

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November 2007


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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