We analyzed the development of nevirapine (NVP) resistance in human immunodeficiency virus type 1 (HIV-1)-infected Malawian infants who received regimens containing single-dose NVP (SD-NVP) for the prevention of mother-to-child transmission (MTCT) of HIV-1. All infants received SD-NVP, and some randomly received zidovudine (ZDV) as well. Mothers did or did not receive SD-NVP on the basis of when they arrived at the hospital for delivery. In infants 6-8 weeks of age, NVP resistance was less frequent when infants had received SD-NVP plus ZDV and mothers had not received SD-NVP than when infants had received SD-NVP alone and mothers had received SD-NVP (4/15 [27%] vs. 20/23 [87%]; P < .001). The risk of MTCT of HIV-1 was comparable with these regimens. Infant-only prophylaxis also eliminates the development of NVP resistance in mothers.
Bibliographical noteFunding Information:
Financial support: the HIV Network for Prevention Trials and the National Institute of Allergy and Infectious Diseases INlAID), National Institutes of Health INIHI. Department of Health and Human Services IDHHSllcontract N01-AI-35173 with Family Health International, contract N01-AI-45200 with the Fred Hutchinson Cancer Research Center, and a subcontract with Makerere University [N01-AI-35173-41711; the HIV Prevention Trials Network, which is sponsored by NIAID, the National Institute of Child Health and Human Development (NICHOl. the National Institute on Drug Abuse, the National Institute of Mental Health, and the Office of AIDS Research, NIH, OHHS (contracts U01-AI-46745 and U01-AI-48054); the Adult AIDS Clinical Trials Groups, Division of AIDS, NIAID, NIH Icontract U01-AI-38858); NICHD (grant R01-HD042965-01); AIDS Fogarty International Research and Collaboration Award (5R03TWOl1991 and supplement from the Fogarty International Center, NIH; National Science Foundation Energy Information Administration (grant 02-051161; the Doris Duke Charitable Foundation, New York.