A New Strategy for Treating HIV-Infected Children Previously Exposed to Nevirapine?

Protease inhibitor (PI)-based regimens are currently recommended for treating HIV-infected children with previous exposure to nevirapine, because of the high incidence of nevirapine resistance in these children (JW AIDS Clin Care Sep 13 2010). However, PI-based regimens are less tolerable, more costly, and more toxic than nevirapine-based regimens, and their use limits the patient's options for second-line therapy. In this randomized controlled trial, researchers assessed whether children who achieved virologic suppression on PI-based regimens could safely switch to nevirapine, despite previous exposure to the drug.

The study involved 195 HIV-infected children in South Africa who had been exposed to nevirapine and then achieved virologic sup…