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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Transmission rates in consecutive pregnancies exposed to single-dose nevirapine in Soweto, South Africa and Abidjan, Côte d'Ivoire
Journal of Acquired Immune Deficiency Syndromes, Volume 45, No. 2, Year 2007
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Description
BACKGROUND: Large numbers of women receive single-dose nevirapine (sdNVP) to prevent mother-to-child transmission (MTCT) of HIV; over time, an increasing proportion will return to prevention of MTCT programs for a second pregnancy. Because sdNVP selects resistance in a high percentage of women, we compared the effectiveness of sdNVP in preventing peripartum MTCT in successive pregnancies. METHODS: Prospective cohorts were recruited from MTCT programs in South Africa and Côte d'Ivoire. HIV-1-infected women and their infants exposed to sdNVP in 2 consecutive pregnancies-used alone or with zidovudine (ZDV) or ZDV plus lamivudine-were included. RESULTS: The median age of women at their initial exposure to sdNVP in Soweto (n = 120) and Abidjan (n = 41) was 26 (interquartile range [IQR]: 22-29) years and 28 (IQR: 24-31) years, respectively, and their median delivery interval was 21 (IQR: 15-29) months and 26 (IQR: 20-32) months, respectively. Transmission rates in Soweto and in Abidjan were 11.1% and 13.2% for the first pregnancy and 11.1% and 5.4% for the second pregnancy (P = 1.000 and P = 0.449 for Soweto and Abidjan, respectively, in unpaired analysis). CONCLUSION: This analysis suggests that the effectiveness of sdNVP when used in successive pregnancies is probably not impaired, possibly because viral resistance selected by prior exposure to sdNVP may wane with time. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Martinson, Neil Alexander
United States, Baltimore
Johns Hopkins University
South Africa, Johannesburg
Perinatal Hiv Research Unit
Ékouévi, Didier Koumavi
Cote D'ivoire, Abidjan
Anrs 1201/1202 Ditrame Plus Project
Dabis, Franćois Ç.Ois
France, Paris
Inserm
Morris, Lynn
South Africa, Johannesburg
National Institute for Communicable Diseases
Lupodwana, Pumla
South Africa, Johannesburg
University of the Witwatersrand
Tonwe-Gold, Besigin
Cote D'ivoire, Abidjan
Aconda-vs-ci
Dhlamini, Puleng
South Africa, Johannesburg
University of the Witwatersrand
Becquet, Renaud
France, Paris
Inserm
Steyn, Jan G.
South Africa, Johannesburg
University of the Witwatersrand
Leroy, Valeriane
France, Paris
Inserm
Viho, Ida
Cote D'ivoire, Abidjan
Aconda-vs-ci
Gray, Glenda E.
South Africa, Johannesburg
University of the Witwatersrand
McIntyre, James Alasdair
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 43
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.1097/QAI.0b013e318050d652
ISSN:
15254135
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Locations
Ivory Coast
South Africa
Participants Gender
Female