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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Researchers have determined that a $4 dose of Nevirapine, which is 70 times cheaper than a short course of AZT therapy, is more effective than the AZT treatment in reducing the transmission of HIV from mother to baby. About 1,800 infants are born each day with HIV infection, and an estimated 45 percent of pregnant women in South Africa will be infected by the end of the year. The Nevirapine therapy still remains too expensive for much of the world, and there are still many women who are not tested during pregnancy and do not know they are at risk of transmitting the disease. Because of the stigma, many African women decline testing even when it is free and treatment is available. A study in Uganda found that Nevirapine lowers the risk of HIV transmission by breast feeding by nearly 50 percent during a baby's first four months. Vertical transmission remains a difficult issue, especially where contaminated water supplies could put an infant at risk for other infections when they are fed formula mixed with contaminated water.
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PMID:Can a $4 drug stop vertical HIV transmission? 1136 85

Researchers in Uganda have discovered an alternative treatment to AZT for reducing perinatal transmission of HIV. One dose of Nevirapine (Viramune), an antiretroviral drug, lowered the incidence of mother-to-child transmission to 13 percent. The drug is meant to be taken by an HIV-positive mother in labor, and by a newborn up to three days old. The comparatively low cost and easy administration makes this therapy a viable alternative in developing countries.
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PMID:Perinatal transmission. 1136 2

People with HIV/AIDS often develop hypersensitivity to certain drugs, particularly Nevirapine (Viramune). This drug causes reactions, including a rash, in more than 33 percent of people who use it. A life-threatening rash, known as Stevens-Johnson syndrome, occurs in 1 percent of patients using Nevirapine. Doctors in France conducted a desensitization program on three subjects who developed rash or hives, high fever, swollen eyes and painful muscles after starting the medication. Patients were given gradually increasing doses of Nevirapine and monitored for reactions. Two subjects developed mild itching, which cleared up after receiving Allegra; the third subject did not respond to the treatment.
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PMID:Desensitization to Nevirapine. 1136 44

Research is being done to find a more feasible regimen for preventing mother-to-child HIV transmission (vertical transmission) world-wide. A three-step regimen of AZT has been proven to reduce the rate of vertical transmission. However, this regimen, which is given over many weeks, is often unaffordable and inaccessible in developing nations. Studies indicate that a shorter course of AZT or a two-dose regimen of Nevirapine (Viramune) is also effective in reducing the rate of vertical transmission. Although the results are preliminary, these treatments may provide developing countries with a low cost, accessible regimen.
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PMID:Simpler regimens for preventing mother-to-child HIV transmission. 1136 61

Results of five studies evaluate treatments for reducing perinatal transmission of HIV. Pediatric trial ACTG 185 evaluated AZT plus two types of immunoglobulin given beginning at 20-30 weeks gestation. Results showed that mothers with low CD4 counts, or who started therapy with AZT during gestation, had a lower incidence of transmission. Trials in Thailand tested 3 regimens of AZT which were given from 36 weeks gestation through delivery, with no breastfeeding. The transmission rate was 51 percent lower than in the placebo arm of the trial. A comparable trial in a breastfeeding population in the Ivory Coast showed a 44 percent decrease in transmission to infants at 4 weeks of age. The UNAIDS-sponsored PETRA study, administered in three African countries, compared three treatment regimens of AZT and 3TC and a placebo. The researcher found that short course combination therapy for the mother during labor and for the infant in the first week of life was as effective as a longer treatment regimen. However, breastfeeding may eventually alter transmission, and the expense of the regimen makes it inaccessible to women in poor countries. Nevirapine, given as a single dose to the mother at the onset of labor with or without a single dose given to the infant within 72 hours of birth, is an alternative to these drugs. A recent study of Nevirapine in Uganda (HIVNET 006) showed significant declines in plasma HIV levels, and the cost for treating both mother and baby was affordable. Despite these advances, there is a great need for effective and affordable regimens in developing countries.
Hopkins HIV Rep 1999 May
PMID:Progress in reducing mother-to-infant HIV transmission. 1136 70

The steady-state pharmacokinetics of efavirenz and nevirapine, when used in combination to treat human immunodeficiency virus type 1 (HIV-1)-infected subjects, were investigated. HIV-1-infected persons who had used efavirenz (600 mg once daily) for > or =2 weeks were eligible for study inclusion. The plasma pharmacokinetics of efavirenz were determined over 24 h. Subsequently, nevirapine (400 mg once daily) was added to the regimen. After 4 weeks, the pharmacokinetics of efavirenz and nevirapine were assessed over 24 h. The differences between the pharmacokinetic parameters of efavirenz with and without nevirapine were analyzed, and the pharmacokinetics of nevirapine were compared with those in historical control patients. The exposure to efavirenz when combined with nevirapine was significantly decreased by 22% (area under the plasma concentration vs. time curve), 36% (minimum plasma concentration), and 17% (maximum plasma concentration). Nevirapine pharmacokinetics appear to be unaffected by coadministration of efavirenz, compared with data from historical control patients.
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PMID:The steady-state pharmacokinetics of efavirenz and nevirapine when used in combination in human immunodeficiency virus type 1-infected persons. 1180 5

Nevirapine plasma levels were measured in 70 HIV-infected patients, 33 of whom developed transaminase elevations. Higher nevirapine levels and hepatitis C virus infection were found to be independent predictors of liver toxicity. Moreover, in individuals with chronic hepatitis C, nevirapine concentrations greater than 6 microg/ml were associated with a 92% risk of liver toxicity. Therefore, monitoring nevirapine levels, especially in individuals with chronic hepatitis C, may be warranted.
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PMID:Liver toxicity caused by nevirapine. 1580 81

Nevirapine (Viramune, Boehringer Ingelheim) is a non-nucleoside reverse transcriptase (RT) inhibitor (NNRTI) effective in the treatment of HIV-1 infected antiretroviral-naive and -experienced patients. Some recent studies have suggested that nevirapine-based regimens may have an efficacy similar to protease inhibitor (PI)-based regimens, at least in naive patients with CD4+ > 200 microl, while it lacks the drawbacks inherent in PI-containing regimens, such as lipodystrophy and metabolic alterations. Switching from a PI-containing regimen to a nevirapine-containing regimen seems to retain the virological response to therapy and it may also limit or reverse the development of some metabolic disorders induced by PIs. Nevirapine is also effective in preventing mother-to-child transmission of HIV-1 disease and in the treatment of HIV-1 infected children. Nevirapine is well-tolerated, rash being the most common severe adverse effect observed. Hepatotoxicity may also appear with nevirapine, mainly in patients with chronic hepatitis C and/or altered liver function tests. This side effect may occasionally be life-threatening but it can be safely managed in most patients.
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PMID:The role of nevirapine in the treatment of HIV-1 disease. 1182 35

Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) develops quickly and independently if they are used in combination with NRTIs or protease inhibitors (PIs) as rescue therapy, mainly due to the low genetic barrier of this class of drugs. In this study we examined clinical, therapeutic, and virologic characteristics in 88 patients with mutations conferring resistance to NNRTIs, and in 11 patients 1 year after stopping NNRTI therapy. Between patients administered Nevirapine (NVP) and those taking Efavirenz (EFV), no statistical differences were found in CD4 cell count, HIV viral load, time on NNRTI therapy, or number of PIs administered previously. A slow decline in the detectability of mutations encoding NNRTI resistance was found.
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PMID:Genotype resistance profiles in patients failing an NNRTI-containing regimen, and modifications after stopping NNRTI therapy. 1194 95

It is estimated that each HIV-positive child in South Africa costs the government more in terms of health and welfare expenses than it does to reduce mother-to-child transmission (MTCT) of HIV through the use of antiretroviral regimens (where the mother continues to breast-feed). Programmes to reduce MTCT of HIV/AIDS are, thus, clearly affordable. Using Nevirapine (according to the HIVNET 012 Protocol) saves more lives and [corrected] is more cost-effective than using Zidovudine (CDC 2 weeks regime).
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PMID:Paying to waste lives: the affordability of reducing mother-to-child transmission of HIV in South Africa. 1202 66


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