Nevirapine sustains reduction of mother-to-child HIV transmission at 18 months ☆

Abstract Question How safe and effective is intrapartum and neonatal single-dose nevirapine vs. multiple dose zidovudine for prevention of mother-to-child HIV transmission throughout 18 months of follow-up? Study design Open randomised controlled trial. Main results Significantly more babies were infected with HIV in the zidovudine group ( n =308) compared with the nevirapine group ( n =311) at 6–8 weeks ( n =59 vs. 36, p =0.006), 14–16 weeks ( n =65 vs. 41, p =0.006), 12 months ( n =70 vs. 46, p =0.008) and 18 months ( n =75 vs. 47, p =0.002). At 18 months, nevirapine reduced the relative risk of transmission of HIV by 41% (95% CI 16 to 59) compared with zidovudine. During the 18 months, serious adverse events had occurred in 97 and 109 women from the zidovudine and nevirapine groups respectively ( p =0.48), with one event from each group being attributed to the treatments. The rate of serious adverse events in babies did not differ between groups. Authors’ conclusions Treating mothers and neonates with a single dose of nevirapine is associated with a lower rate of vertical HIV transmission without any evidence of an increase in serious adverse events over 18-months follow-up.