Maternal Antiretroviral Therapy and Infant Nevirapine Can Prevent Breast-Feeding–Associated HIV Transmission

Postpartum viral rebound and breast-feeding–related HIV transmission remain persistent problems in resource-limited settings despite recommendations that all HIV-infected pregnant women initiate lifelong antiretroviral therapy (ART). In a head-to-head study, researchers assessed the efficacy and safety of maternal ART (mART; ritonavir-boosted lopinavir/tenofovir DF/emtricitabine) versus age-based infant dosing of nevirapine (iNVP). Mother-infant pairs (mothers with confirmed HIV infection; infants aged ≤14 days confirmed to be uninfected) at 14 sites in sub-Saharan Africa and India were randomized 1:1 to either treatment.

In all, 2431 mother-infant pairs were enrolled (median maternal CD4 count, 686 cells/mm³). Seven infants in each treatmen…