STUDY OBJECTIVE: To evaluate the effect of a previous single dose of nevirapine given to prevent mother-to-child transmission of human immunodeficiency virus (HIV) on virologic and immunologic measures after months of an antiretroviral regimen containing either efavirenz or lopinavir-ritonavir. DESIGN: Retrospective subgroup analysis of data from the Phidisa II trial. SETTING: Six South African research clinics. Patients. A total of 394 women with HIV who completed 6 months of combination antiretroviral regimen containing either efavirenz or lopinavirritonavir as part of the Phidisa II trial. MEASUREMENTS AND MAIN RESULTS: During the screening process for the Phidisa II study, 478 women were asked about previous nevirapine use: 392 women (82%) were nevirapine naïve, and 86 (18%) had received nevirapine. During the study, patients received either an efavirenz-based or lopinavir-ritonavir- based antiretroviral regimen. After 6 months of treatment, virologic (HIV RNA levels) and immunologic (CD4(+) cell count) responses were measured. These data were compared between women with or without previous nevirapine exposure, and between women who received efavirenz versus lopinavirritonavir. After 6 months of treatment, 394 women (324 nevirapine naïve, 70 exposed to nevirapine) had follow-up HIV RNA results. Two hundred twenty-seven (70.1%) of the nevirapine-naïve patients and 48 (68.6%) of the nevirapine-exposed patients achieved HIV RNA levels lower than 400 copies/ml (p=0.89), with CD4(+) cell count increases of 115.5 and 120.4 cells/mm(3), respectively (p=0. 7). Among the nevirapine-exposed women, 27 (75%) of 36 efavirenz-treated and 21 (61.8%) of 34 lopinavir-ritonavir-treated patients had HIV RNA levels lower than 400 copies/ml at months (p=0.31). CONCLUSION: In this retrospective analysis of a small cohort, previous exposure to a single dose of nevirapine did not affect virologic outcomes after 6 months of either an efavirenz-based or lopinavir-ritonavir-based antiretroviral regimen. As efavirenz is one of the first-line combination antiretroviral therapies administered in Africa, it remains an option for women who received single-dose nevirapine.
STUDY OBJECTIVE: To evaluate the effect of a previous single dose of nevirapine given to prevent mother-to-child transmission of human immunodeficiency virus (HIV) on virologic and immunologic measures after months of an antiretroviral regimen containing either efavirenz or lopinavir-ritonavir. DESIGN: Retrospective subgroup analysis of data from the Phidisa II trial. SETTING: Six South African research clinics. Patients. A total of 394 women with HIV who completed 6 months of combination antiretroviral regimen containing either efavirenz or lopinavirritonavir as part of the Phidisa II trial. MEASUREMENTS AND MAIN RESULTS: During the screening process for the Phidisa II study, 478 women were asked about previous nevirapine use: 392 women (82%) were nevirapine naïve, and 86 (18%) had received nevirapine. During the study, patients received either an efavirenz-based or lopinavir-ritonavir- based antiretroviral regimen. After 6 months of treatment, virologic (HIV RNA levels) and immunologic (CD4(+) cell count) responses were measured. These data were compared between women with or without previous nevirapine exposure, and between women who received efavirenz versus lopinavirritonavir. After 6 months of treatment, 394 women (324 nevirapine naïve, 70 exposed to nevirapine) had follow-up HIV RNA results. Two hundred twenty-seven (70.1%) of the nevirapine-naïve patients and 48 (68.6%) of the nevirapine-exposed patients achieved HIV RNA levels lower than 400 copies/ml (p=0.89), with CD4(+) cell count increases of 115.5 and 120.4 cells/mm(3), respectively (p=0. 7). Among the nevirapine-exposed women, 27 (75%) of 36 efavirenz-treated and 21 (61.8%) of 34 lopinavir-ritonavir-treated patients had HIV RNA levels lower than 400 copies/ml at months (p=0.31). CONCLUSION: In this retrospective analysis of a small cohort, previous exposure to a single dose of nevirapine did not affect virologic outcomes after 6 months of either an efavirenz-based or lopinavir-ritonavir-based antiretroviral regimen. As efavirenz is one of the first-line combination antiretroviral therapies administered in Africa, it remains an option for women who received single-dose nevirapine.
Authors: Shahin Lockman; Roger L Shapiro; Laura M Smeaton; Carolyn Wester; Ibou Thior; Lisa Stevens; Fatima Chand; Joseph Makhema; Claire Moffat; Aida Asmelash; Patrick Ndase; Peter Arimi; Erik van Widenfelt; Loeto Mazhani; Vladimir Novitsky; Stephen Lagakos; Max Essex Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Tamara S Flys; Deborah Donnell; Anthony Mwatha; Clemensia Nakabiito; Philippa Musoke; Francis Mmiro; J Brooks Jackson; Laura A Guay; Susan H Eshleman Journal: J Infect Dis Date: 2007-01-18 Impact factor: 5.226
Authors: S H Eshleman; L A Guay; A Mwatha; S P Cunningham; E R Brown; P Musoke; F Mmiro; J B Jackson Journal: AIDS Res Hum Retroviruses Date: 2004-06 Impact factor: 2.205
Authors: F van Leth; P Phanuphak; K Ruxrungtham; E Baraldi; S Miller; B Gazzard; P Cahn; U G Lalloo; I P van der Westhuizen; D R Malan; M A Johnson; B R Santos; F Mulcahy; R Wood; G C Levi; G Reboredo; K Squires; I Cassetti; D Petit; F Raffi; C Katlama; R L Murphy; A Horban; J P Dam; E Hassink; R van Leeuwen; P Robinson; F W Wit; J M A Lange Journal: Lancet Date: 2004-04-17 Impact factor: 79.321
Authors: Sharon A Riddler; Richard Haubrich; A Gregory DiRienzo; Lynne Peeples; William G Powderly; Karin L Klingman; Kevin W Garren; Tania George; James F Rooney; Barbara Brizz; Umesh G Lalloo; Robert L Murphy; Susan Swindells; Diane Havlir; John W Mellors Journal: N Engl J Med Date: 2008-05-15 Impact factor: 91.245
Authors: Elise Arrivé; Marie-Louise Newell; Didier K Ekouevi; Marie-Laure Chaix; Rodolphe Thiebaut; Bernard Masquelier; Valériane Leroy; Philippe Van de Perre; Christine Rouzioux; François Dabis Journal: Int J Epidemiol Date: 2007-05-28 Impact factor: 7.196