Use of single-dose nevirapine for the prevention of mother-to-child transmission of HIV-1: does development of resistance matter?

作者：McConnell Michelle S^*; Stringer Jeffrey S A; Kourtis Athena P; Weidle Paul J; Eshleman Susan H

来源：American Journal of Obstetrics and Gynecology, 2007, 197(3): S56-S63.

DOI：10.1016/j.ajog.2007.02.031

• nevirapine
• PMTCT
• resistance
• treatment

Nevirapine resistance has been detected in a considerable proportion of women after single-dose nevirapine (SD-NVP) for the prevention of mother-to-child human immunodeficiency virus-1 transmission. As a result, concern has been raised about the effectiveness of subsequent nevirapine-based treatment. Studies in Thailand, Botswana, and South Africa have assessed virologic treatment response after SD-NVP. These studies did not find any significant difference in virologic response for women who began treatment > 6 months after SD-NVP exposure. Two studies found worse response rates in women when treatment was initiated within 6 months of SD-NVP exposure. Furthermore, 2 studies found no difference in human immunodeficiency virus transmission rates from mother to child after the receipt of SD-NVP in repeat pregnancies. These data support the use of SD-NVP as 1 option for the prevention of mother-to-child human immunodeficiency virus-1 transmission in resource-limited settings, particularly in settings where more complex regimens are not yet available. Further research in the optimization of perinatal prevention regimens is needed.

• 出版日期2007-9