Preventing HIV Drug Resistance in Mothers

Intrapartum single-dose nevirapine (sd-NVP), taken to prevent transmission of HIV from infected mothers to their infants, is an important intervention in many resource-limited settings. However, after use of sd-NVP, women and their infants often develop resistance to nonnucleoside reverse-transcriptase inhibitors (NNRTIs). Might adding a single dose of intrapartum tenofovir/emtricitabine (TDF/FTC) reduce the prevalence of NNRTI resistance in women who receive sd-NVP?

To find out, researchers randomized 400 HIV-infected pregnant women in Zambia (none of whom met WHO criteria for starting combination antiretroviral therapy [ART] for their own health) to receive TDF/FTC or no study drug during labor. All participants were offered antenatal zido…