Extended prophylaxis with nevirapine or nevirapine plus zidovudine in breastfeeding infants born to HIV-1-infected mothers decreases postnatal HIV-1 infection" />

December 2008. Volume 4. Number 4

Extended prophylaxis with nevirapine or nevirapine plus zidovudine in breastfeeding infants born to HIV-1-infected mothers decreases postnatal HIV-1 infection

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC, Kafulafula G, Li Q et al. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med. 2008;359:119-29
Reviewers: Chalco Orrego JP1, Bada Mancilla CA2.
1Pediatra independiente. Lima. Perú.
2Servicio de Urgencias. Hospital de Emergencias Pediátricas. Lima. Perú.
Correspondence: Juan Pablo Chalco Orrego. Email: jpcho33@yahoo.com
Reception date: 28/10/2008
Acceptance date: 15/11/2008
Publication date: 01/12/2008

Abstract

Authors' conclusions: extended prophylaxis with nevirapine or with nevirapine plus zidovudine significantly reduced postnatal HIV-1 infection in 9-month-old infants.

Reviewers' comantary: postnatal transmission of HIV-1 among breast-feeding children is a major concern mainly in sub-Saharan countries. Antiviral treatments like a single dose of nevirapine plus zidovudine for 1 to 4 have been used in newborns for its prevention. This trial concluded that an extended nevirapine prophylaxis is related to a decreased rate of infection at nine months although it fails in describe some related outcomes like a higher resistance rate mentioned by other authors. So, with the actual knowledge, it does not seem yet recommendable to change to extended nevirapine regimens.

How to cite this article

Chalco Orrego JP, Bada Mancilla CA. En hijos recién nacidos de madres con infección por VIH-1 alimentados con lactancia materna, la profilaxis prolongada con nevirapina o nevirapina más zidovudina disminuye la infección postnatal por VIH-1. Evid Pediatr. 2008;4:85.

AVC | Critically appraised articles

Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC, Kafulafula G, Li Q et al. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med. 2008;359:119-29
Reviewers: Chalco Orrego JP1, Bada Mancilla CA2.
1Pediatra independiente. Lima. Perú.
2Servicio de Urgencias. Hospital de Emergencias Pediátricas. Lima. Perú.
Correspondence: Juan Pablo Chalco Orrego. Email: jpcho33@yahoo.com
Reception date: 28/10/2008
Acceptance date: 15/11/2008
Publication date: 01/12/2008

How to cite this article

Chalco Orrego JP, Bada Mancilla CA. En hijos recién nacidos de madres con infección por VIH-1 alimentados con lactancia materna, la profilaxis prolongada con nevirapina o nevirapina más zidovudina disminuye la infección postnatal por VIH-1. Evid Pediatr. 2008;4:85.

References

  1. WHO, UNICEF, UNAIDS. Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report 2008. June 2, 2008. [en línea] [fecha de consulta: 28-X-2008]. URL disponible en: http://www.who.int/hiv/pub/towards_universal_access_report_2008.pdf
  2. WHO HIV and Infant Feeding Technical Consultation held on behalf of the Interagency Task Team (IATT) on Prevention of HIV Infection in Pregnant Women, Mothers and their Children, Geneva, October 25–27, 2006: consensus statement. Geneva, World Health Organization, 2006. [en línea] [fecha de consulta: 28-X-2008]. URL disponible en: http://whqlibdoc.who.int/publications/2007/9789241595964_eng.pdf
  3. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: towards universal access: recommendations for a public health approach. – 2006 version. [en línea] [fecha de consulta: 28-X-2008]. URL disponible en: http://www.who.int/hiv/pub/guidelines/pmtctguidelines3.pdf
  4. Six Week Extended-Dose Nevirapine (SWEN) Study Team, Bedri A, Gudetta B, Isehak A, Kumbi S, Lulseged S, Mengistu Y et al. Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomised controlled trials. Lancet. 2008;372:300-13.
  5. Church JD, Omer SB, Guay LA, Huang W, Lidstrom J, Musoke P et al. Analysis of nevirapine (NVP) resistance in Ugandan infants who were HIV infected despite receiving single-dose (SD) NVP versus SD NVP plus daily NVP up to 6 weeks of age to prevent HIV vertical transmission. J Infect Dis. 2008;198:1075-82.
01/12/2008

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