Low Rate of Mother-to-Child Transmission of HIV-1 After Nevirapine Intervention in a Pilot Public Health Program in Yaound??, Cameroon

Ayouba, Ahidjo; Tene, Gilbert; Cunin, Patrick; Foupouapouognigni, Yacouba; Menu, Elisabeth; Kfutwah, Anfumbom; Thonnon, Jocelyn; Scarlatti, Gabriella; Monny-Lobe, M.; Eteki, N; Kouanfack, Charles; Tardy, Michèle; Leke, Robert J. I.; Nkam, M; Nlend, Anne Esther Njom; Barré‐Sinoussi, Françoise; Martin, Paul; Nerrienet, Eric

doi:10.1097/00126334-200311010-00003

Cited by 58 publications

(40 citation statements)

References 13 publications

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“…In resource-limited settings, where ART often is not available, pregnant HIV-infected women are given a single dose of the NNRTI nevirapine (NVP) at the onset of labor (4,24,28,34,41,57). This inexpensive treatment of the mother and in some cases also the infant can significantly decrease mother-to-child transmission by as much as 50%.…”

mentioning

confidence: 99%

Suppression of Viremia and Evolution of Human Immunodeficiency Virus Type 1 Drug Resistance in a Macaque Model for Antiretroviral Therapy

Ambrose

Palmer

Boltz

et al. 2007

J Virol

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Antiretroviral therapy (ART) in human immunodeficiency virus type 1 (HIV-1)-infected patients does notclear the infection and can select for drug resistance over time. Not only is drug-resistant HIV-1 a concern for infected individuals on continual therapy, but it is an emerging problem in resource-limited settings where, in efforts to stem mother-to-child-transmission of HIV-1, transient nonnucleoside reverse transcriptase inhibitor (NNRTI) therapy given during labor can select for NNRTI resistance in both mother and child. Questions of HIV-1 persistence and drug resistance are highly amenable to exploration within animals models, where therapy manipulation is less constrained. We examined a pigtail macaque infection model responsive to anti-HIV-1 therapy to study the development of resistance. Pigtail macaques were infected with a pathogenic simian immunodeficiency virus encoding HIV-1 reverse transcriptase (RT-SHIV) to examine the impact of prior exposure to a NNRTI on subsequent ART comprised of a NNRTI and two nucleoside RT inhibitors. K103N resistance-conferring mutations in RT rapidly accumulated in 2/3 infected animals after NNRTI monotherapy and contributed to virologic failure during ART in 1/3 animals. By contrast, ART effectively suppressed RT-SHIV in 5/6 animals. These data indicate that suboptimal therapy facilitates HIV-1 drug resistance and suggest that this model can be used to investigate persisting viral reservoirs.

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mentioning

confidence: 99%

Suppression of Viremia and Evolution of Human Immunodeficiency Virus Type 1 Drug Resistance in a Macaque Model for Antiretroviral Therapy

Ambrose

Palmer

Boltz

et al. 2007

J Virol

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“…NVP has been used widely to prevent HIV-1 MTCT in developing countries [7][8][9][10][11]. However, a single dose of NVP is associated with the development of NVP resistant virus in mothers and their infants who become infected with HIV [56].…”

Section: Impact Of Cyp2b6 Genotype On Hiv-1 Mtct and Development Of Nmentioning

confidence: 99%

“…EFV has been included in the majority of treatment guidelines as the preferred first-line regimen for HIVinfected adults [101] and children >3 year old [102] in the United States as well as outside of the United States [103]. NVP has been used in HIV-infected infants, children and adults not only as a component of HAART [101][102][103], but also for the prevention of mother-to-child transmission (MTCT) [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Effect of Host Genetic Variation on the Pharmacokinetics and Clinical Response of Nnrtis

Saitoh

Spector

2007

Future HIV Ther.

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Non-nucleoside reverse transcriptase inhibitors (NNRTIs) have been used widely for treating human immunodeficiency virus type 1 (HIV-1) infected patients as a component of highly active antiretroviral therapy (HAART) and for the prevention of mother-to-child transmission (MTCT). Cytochrome P450 (CYP) 2B6 is an important hepatic isoenzyme responsible for the metabolism of NNRTIs including efavirenz and nevirapine. Recent pharmacogenetic studies have shown that CYP2B6 genetic variants alter hepatic CYP2B6 protein expression and function, and the pharmacokinetics of several CYP2B6 substrates. In particular, the CYP2B6-G516T polymorphism in exon 4 affects the pharmacokinetics of efavirenz. Other studies have shown associations of the CYP2B6-G516T genotype with nevirapine pharmacokinetics and central nervous system adverse effects related to efavirenz use. In total, CYP2B6 genetic variants are important determinants of efavirenz and nevirapine pharmacokinetics . Further studies are needed to identify the associations of CYP2B6 genetic variants with the development of NNRTI resistant viruses.

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“…Some success in reducing perinatal transmission through the use of single oral doses of nevirapine delivered to both the mother and newborn has also been documented. 14 Particularly, promising results have been seen in Africa, where simple, inexpensive perinatal preventative regimens are especially needed.…”

Section: Transmissionmentioning

confidence: 99%

The Pharmacotherapy of the Modern Day Epidemic Infection with Human Immunodeficiency Virus (HIV)

Romanelli¹

2005

Am J Pharm Educ

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Infection with Human Immunodeficiency Virus (HIV) and the resultant Acquired Immunodeficiency Syndrome (AIDS) have reached pandemic proportions, causing approximately 20 million deaths worldwide. HIV pharmacotherapy is a complex and rapidly evolving area. Educators are challenged to provide pharmacy students with current, specific, and practical information in this highly specialized area. This paper describes a learning experience in HIV/AIDS which incorporates basic HIV epidemiology, pathophysiology, and pharmacotherapy. The experience also emphasizes the psychosocial aspects of the disease which can among other things impact adherence. Mini-cases and a clinic medication history form that are used to assist students in assimilating information and relating it to patient care are also discussed.

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Low Rate of Mother-to-Child Transmission of HIV-1 After Nevirapine Intervention in a Pilot Public Health Program in Yaound??, Cameroon

Abstract: Our results indicate that the HIV-1 MTCT rate 6-8 weeks after NVP administration was not >13% (16/123), thus demonstrating the effectiveness of NVP for lowering the risk of HIV-1 MTCT in real-life settings.

Cited by 58 publications

References 13 publications

Suppression of Viremia and Evolution of Human Immunodeficiency Virus Type 1 Drug Resistance in a Macaque Model for Antiretroviral Therapy

Suppression of Viremia and Evolution of Human Immunodeficiency Virus Type 1 Drug Resistance in a Macaque Model for Antiretroviral Therapy

Effect of Host Genetic Variation on the Pharmacokinetics and Clinical Response of Nnrtis

The Pharmacotherapy of the Modern Day Epidemic Infection with Human Immunodeficiency Virus (HIV)

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