[pronut-hiv] Nevirapine Resistance Poses No Long-Term Risk

["ProNut-HIV" <pronut-hiv@healthnet.org>]

Nevirapine Resistance Poses No Long-Term Risk
The Herald (Harare)
March 9, 2006 
Harare 

NEVIRAPINE resistance poses no long-term risk to HIV positive mothers.

This means women who take a single dose of the drug to prevent
transmission of HIV to their babies can still use Nevirapine
successfully in subsequent pregnancies and for their own long-term care,
a report by the Elizabeth Glaser Pediatric Aids Foundation says.

The report comes at a time when the use of Nevirapine by pregnant women
was viewed with suspicion.

Critics said women who took the drug to prevent mother-to-child
transmission (PMTCT) would develop resistance to the drug and could not
use it in their next pregnancy or for their own treatment afterwards.

Some countries such as South Africa have since banned the use of the
drug in PMTCT but Zimbabwe has steadfastly continued using it.

Several key studies presented at the Conference on Retroviruses and
Opportunistic Infections, which took place in the United States earlier
this month, have provided promising data about the long-term impact of
Nevirapine resistance on women who took the drug for PMTCT.

According to the studies, women who took single-dose Nevirapine
responded favourably to the drug in a subsequent pregnancy or as part of
combination therapy as women who have never been exposed to the drug.

Dr Cathy Wilfert, scientific director of the Elizabeth Glaser Pediatric
Foundation, a leading provider of services to prevent mother-to-child
transmission, said the studies were good news for HIV positive women who
could now take the drug to prevent transmission to their babies without
unnecessary worries about the implications.

"It is clear that there are multiple strategies to prevent infant HIV
infection while safeguarding the health of HIV positive mothers," she
said.

At last year's Conference on Retroviruses and Opportunities Infections,
several studies raised alarm by demonstrating that women who took
single-dose Nevirapine to prevent mother-to-child transmission of HIV
showed resistance to the drug.

However, more studies were needed to determine if the resistance had
any negative impact on the women's subsequent treatment options.

Elizabeth Glaser Foundation said it was committed to providing women
with the safest and most effective options to prevent infant infections
and safeguard their own health.

Most women around the world do not have access to any intervention to
prevent mother-to-child transmission.

For these women, single-dose Nevirapine remained a safe and effective
option. For those in areas that have more resources and infrastructure,
other options were advisable.

"In every case, we must provide women with the best option available,
working in accord with the national HIV policies of the host country,"
said Dr Wilfert.

The studies were conducted in Zimbabwe, Uganda, South Africa, Cote
d'Ivoire and Argentina.

In all cases, it was established that women who repeated use of
single-dose Nevirapine in subsequent pregnancies experienced no
increased risk of infant infection as compared to those without prior
exposure to the drug.