Timing of maternal and neonatal dosing of nevirapine and the risk of mother-to-child transmission of HIV-1: HIVNET 024

Benjamin H. Chi, Lei Wang, Jennifer S. Read, Muhsin Sheriff, Susan Fiscus, Elizabeth R. Brown, Taha E. Taha, Megan Valentine, Robert Goldenberg

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Despite a growing emphasis worldwide on complex and potent antiretroviral drug regimens for the prevention of mother-to-child transmission of HIV-1 (MTCT), two-dose nevirapine (NVP) prophylaxis remains an important choice in many settings. We analyzed data from a multicenter clinical trial to determine whether timing of maternal or infant NVP was associated with MTCT between delivery and 6 weeks of age (intrapartum/early postnatal transmission; I/EP). Methods: HIVNET 024 was a placebo-controlled, double-blind trial of empiric antibiotics to reduce chorioamnionitis-associated MTCT. This secondary analysis used data collected in the original randomized trial. Enrolled women were instructed to self-administer NVP at labor onset; infants were to receive a dose within 72 h of birth. Results: Data regarding 1491 mother-infant pairs were analyzed. The overall I/EP HIV-1 transmission rate was 8.1% at 6 weeks. Almost all women (93%) ingested NVP within 24 h of delivery; 90% of infants were given NVP within 48 h after delivery. Variations in mother or infant dose timing did not influence transmission rates, even when the combined pattern of both was taken into account through multivariate analysis. In the subset of women ingesting NVP ≤ 2 h before delivery, early NVP administration to the infant (< 4 h after birth) was not associated with lower MTCT risk when compared with later administration (≥ 4 h). Conclusion: Variations in the timing of maternal and infant NVP doses (within reasonable proximity to delivery) do not appear to affect the risk of MTCT.

Original languageEnglish (US)
Pages (from-to)1857-1864
Number of pages8
JournalAIDS
Volume19
Issue number16
DOIs
StatePublished - Nov 4 2005

Keywords

  • Dose timing
  • HIVNET 024
  • Mother-to-child transmission
  • Nevirapine
  • Prevention of mother-to-child transmission of HIV-1
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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