Lack of Effect from a Previous Single Dose of Nevirapine on Virologic and Immunologic Responses After 6 Months of Antiretroviral Regimens Containing Either Efavirenz or Lopinavir‐Ritonavir

Abstract

Study Objective-To evaluate the effect of prior single dose nevirapine (sd-NVP) use on HIV RNA and CD4+ T-cell responses after 6 months of efavirenz -or lopinavir/ritonavir -based antiretroviral regimens.Design-This is a retrospective analysis of a subset of participants in the Phidisa II trial, a randomized controlled trial enrolled HIV+ participants 14 years or older with no or < 7 day history of antiretroviral use. At screening, subjects were asked about prior nevirapine nevirapine use, a positive response in a woman was used as a surrogate for prior sd-NVP. Virologic and CD4 responses at 6-month were compared between women with or without prior nevirapine exposure, and amongst women who received efavirenz vs. lopinavir/ritonavir. Setting-Six South African Medical Health Services' Phidisa research clinics.Subjects-478 women responded to the question regarding prior nevirapine use.Measurements and Main Results-392 women were nevirapine-naïve (NVP-), 86 had prior nevirapine (NVP+). At 6-month, 396 women (324 NVP-, 70 NVP+) had follow-up HIV-RNA

Efavirenz-based combination antiretroviral therapy after peripartum single-dose nevirapine

“…5,11–14 In only one study prior exposure to sdNVP has decreased response rates to NVP-based cART irrespective of the time elapsed from that exposure. 3 Efficacy at six months of follow-up of EFV-based cART after sdNVP has been demonstrated in another study from South Africa, although the length of time between sdNVP and starting cART was not specified 15 The median increase in CD4 count in this study is comparable with that found in those on a NVP-containing regimen. 3,5…”