Adding nevirapine to the usual zidovudine regimen used to treat newborns of mothers diagnosed with HIV at or shortly before giving birth helps reduce the rate of HIV infection among these infants, according to a study conducted as part of the National Institutes of Health's International Maternal Pediatric Adolescent AIDS Clinical Trials group (IMPAACT).
The researchers randomly assigned 1684 infants from 17 sites in the United States, Brazil, South Africa, and Argentina whose mothers had a peripartum diagnosis of HIV to receive either the usual zidovudine regimen for 6 weeks, this regimen plus 3 doses of nevirapine during the first 8 days of life, or the usual regimen plus nelfinavir and lamivudine for 2 weeks (Nielson-Saines K et al. N Engl J Med. 2012;366:2368-2379). They found that the rate of transmission was 4.8% in the usual care group compared with 2.2% in the usual care plus nevirapine group and 2.4% in the 3-drug group. However, infants in the 3-drug group had elevated rates of neutropenia.
Kuehn BM. Preventing HIV Infections. JAMA. 2012;308(4):331. doi:10.1001/jama.2012.8754