Antiretroviral Therapy After Single-Dose Nevirapine at the Onset of Labor

A single dose of nevirapine administered during labor is used in many developing countries to reduce the risk for perinatal HIV transmission. However, resistance to nevirapine develops rapidly, and women who have received peripartum nevirapine are at increased risk for virologic failure with subsequent nevirapine-based regimens. Investigators prospectively observed 218 HIV-infected women in Botswana who participated in a randomized trial of peripartum single-dose nevirapine versus placebo and subsequently began nevirapine-based antiretroviral treatment. Thirty HIV-infected infants who received nevirapine at birth were also followed.

Overall, 42% of the women who had received peripartum nevirapine and subsequent nevirapine-based therapy withi…