In Reply: Drs Wagner and Frenkel draw attention to the interpretation dilemma raised by our findings: which treatment strategy is classified as superior depends on which virologic outcome is used. Using the protocol-defined primary end point of one virologic measurement greater than 50 copies/mL, the strategy of recycling nevirapine in prophylaxis-exposed children is superior. In contrast, using 2 measurements greater than 1000 copies/mL (a protocol safety net to consider returning children to the ritonavir-boosted lopinavir–based regimen used initially to achieve virologic suppression), no change in regimen is to be preferred. Which conclusion is right?
Coovadia A, Abrams EJ, Kuhn L. Antiretroviral Treatment for HIV-Infected Infants Exposed to Nevirapine—Reply. JAMA. 2010;304(23):2589-2590. doi:10.1001/jama.2010.1819