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December 15, 2010

Antiretroviral Treatment for HIV-Infected Infants Exposed to Nevirapine—Reply

JAMA. 2010;304(23):2589-2590. doi:10.1001/jama.2010.1819

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?