{"id":6472,"date":"2002-05-11T13:16:25","date_gmt":"2002-05-11T12:16:25","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=6472"},"modified":"2014-06-05T12:01:06","modified_gmt":"2014-06-05T12:01:06","slug":"nevirapine-at-the-centre-of-mtct-controversy","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/6472","title":{"rendered":"Nevirapine at the centre of MTCT controversy"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

In recent weeks the spotlight has been on the drug nevirapine and its role in the reduction of mother to child transmission (MTCT).<\/strong><\/p>\n

The results of the HIVNet 012 study \u2014 in which a single dose of nevirapine given to a mother in labour followed by a single dose to her baby was shown to significantly reduce the incidence of mother to child transmission \u2014 and data from other studies supporting these findings, was followed by an application submitted to the US Food and Drug Administration (FDA) by the drug\u2019s manufacturer Boehringer Ingelheim to market the drug for this purpose.<\/p>\n

On examination, the HIVNet 012 results were found to have paperwork irregularities and therefore may not conform to the FDA regulatory requirements, and owing to the timeline for the review, Boehringer then withdrew the application. The company will however continue to support the use of nevirapine and to donate the drug to developing countries for the prevention of mother to child transmission.<\/p>\n

This news of the FDA\u2019s concerns was greeted with alarm by some, provoking statements from the WHO\/UNAIDS, the National Institute of Allergy and Infectious Diseases (NIAID), the Elizabeth Glaser Foundation and several activist groups, defending the drug\u2019s safety and its use within this setting.<\/p>\n

None of these statements, however, addressed the ease with which nevirapine resistance can occur \u2014 from even a single dose \u2014 or the importance of treating the mother\u2019s own disease and risking her future treatment options.<\/p>\n

Meanwhile, in her commentary, reproduced below, following the publication of the results from the PETRA trial which used a two-drug combination of AZT and 3TC to reduce mother to child transmission, Dr Karen Beckerman, writing in The Lancet, criticises these interventions which ignore treatment for maternal disease and the inevitable creation of orphans.<\/p>\n

She asks: \u201cIs it justifiable to visit the antiretroviral mistakes of the industrialised world on regions that have been devastated by the HIV epidemic but are at least antiretrovirally na\u00efve?\u201d<\/p>\n

Beckerman argues for strategies that save the lives of mothers, and continues that the \u201clack is particularly disturbing in view of the developed world\u2019s experience that treatment of maternal HIV disease results in transmission rates far lower than transmission prophylaxis alone.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Polly Clayden, HIV i-Base In recent weeks the spotlight has been on the drug nevirapine and its role in the reduction of mother to child transmission (MTCT). The results of the HIVNet 012 study \u2014 in which a single dose …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-6472","post","type-post","status-publish","format-standard","hentry","category-pmtct-and-maternal-health"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/6472","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=6472"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/6472\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=6472"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=6472"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=6472"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}