Nevirapine: An Option For Preventing Paediatric HIV Infection
Nevirapine: An Option For Preventing Paediatric HIV Infection
Nevirapine belongs to the class of non-nucleoside reverse transcriptase inhibitors (NNRTI) of HIV. It reduces perinatal HIV transmission when administered as a 2-dose regimen, 1 dose to pregnant women during labour and 1 dose to the new born infant within 72 hours of birth. This nevirapine regimen was more effective than a short course of intrapartum and neonatal zidovudine in a randomised trial in breastfeeding women in Uganda. The 2-dose mother-infant nevirapine regimen is well tolerated and is more cost effective and easier to administer in resource-poor settings than zidovudine. In the US, guidelines for the prevention of perinatal HIV transmission suggest the use of the 2-dose nevirapine regimen as one of the possible treatment options for pregnant women who have received no previous antiretroviral therapy and whose infection is diagnosed late in pregnancy or during labour.
Data concerning the use of nevirapine for the treatment of children with established HIV infection are still limited. It should only be used in combination with at least 2 other antiretroviral agents. In small numbers of patients nevirapine-containing triple antiretroviral combination regimens have produced reductions of HIV RNA both in plasma and the CSF.
It has been estimated that >600 000 children acquire HIV infection or AIDS each year worldwide. The majority of these children are from developing countries and most acquire their infection perinatally. Transmission of HIV occurs mainly around the time of labour and delivery but can also be transmitted after birth in breast milk, with the greatest risk of infection via this route occurring in the first few months of life.
Nevirapine belongs to the class of non-nucleoside reverse transcriptase inhibitors (NNRTI) of HIV. It reduces perinatal HIV transmission when administered as a 2-dose regimen, 1 dose to pregnant women during labour and 1 dose to the new born infant within 72 hours of birth. This nevirapine regimen was more effective than a short course of intrapartum and neonatal zidovudine in a randomised trial in breastfeeding women in Uganda. The 2-dose mother-infant nevirapine regimen is well tolerated and is more cost effective and easier to administer in resource-poor settings than zidovudine. In the US, guidelines for the prevention of perinatal HIV transmission suggest the use of the 2-dose nevirapine regimen as one of the possible treatment options for pregnant women who have received no previous antiretroviral therapy and whose infection is diagnosed late in pregnancy or during labour.
Data concerning the use of nevirapine for the treatment of children with established HIV infection are still limited. It should only be used in combination with at least 2 other antiretroviral agents. In small numbers of patients nevirapine-containing triple antiretroviral combination regimens have produced reductions of HIV RNA both in plasma and the CSF.
It has been estimated that >600 000 children acquire HIV infection or AIDS each year worldwide. The majority of these children are from developing countries and most acquire their infection perinatally. Transmission of HIV occurs mainly around the time of labour and delivery but can also be transmitted after birth in breast milk, with the greatest risk of infection via this route occurring in the first few months of life.
