Nevirapine 'works in combination'
Veronica Mohapeloa
19 July 2004
South Africa's Perinatal HIV Research Unit, based at Wits University and Chris Hani Baragwanath Hospital, says it has found a way to minimise resistance to Nevirapine among HIV-positive pregnant women.
Nevirapine, an Aids drug manufactured by Beohringer-Ingelhiem, is at the centre of controversy following the Medicines Control Council's recommendation to have the drug used in combination with other drugs to prevent HIV transmission from mother to child.
The Medicines Control Council (MCC) announced last week that it had reconsidered the merits of the drug as a monotherapy for reducing HIV transmission during pregnancy, saying studies conducted recently in South Africa showed resistance of up to 50% to Nevirapine used by itself.
Nevirapine is administered in South Africa's public health sector to HIV-positive pregnant women in a single dose during labour, followed by a single dose to the baby within 72 hours of birth.
The Perinatal HIV
Research Unit said in response last week that a separate study had found that resistance to Nevirapine was minimised by starting ZDV and 3TC (Combivir®) together with the Nevirapine dose, and by continuing ZDV/3TC for four to seven days after taking Nevirapine.
"The preliminary results suggest that these short course regimens could be a feasible and inexpensive way to protect against resistance and prevent mother to child transmission of HIV", the unit said.
The unit said that while viral resistance to Nevirapine was mostly found in women with high viral loads and low CD4 counts, resistance had been shown to decrease over time.
"However, implications on future maternal antiretroviral therapy or future pregnancy interventions are unclear."
The Perinatal HIV Research Unit supported the MRC's recommendation to move as soon as possible to the more "effective" regimen of ZDV and Nevirapine, wherever this was feasible.
However, the unit also emphasised that
the provision of Nevirapine monotherapy should not be stopped before there were better regimens in place.
It also decried the controversy and public confusion the issue had sparked, saying these undermined the need for better dialogue among researchers, policymakers and activists.
"The PHRU remains committed to high quality research to improve the lives of people living with HIV and to assisting in the dissemination and implementation of these research results."
Source: BuaNews
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