The difference between treatments was most striking among women who initiated therapy in the first 12 to 24 months after nevirapine exposure.
Providing single-dose nevirapine to HIV-infected women during labor is an effective means of reducing mother-to-child transmission (MTCT) of HIV, but it leads to nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance about 60% of the time. Is it safe then for women who receive single-dose nevirapine to later receive nevirapine-based therapy, or would a boosted protease inhibitor (PI) be better? The OCTANE trials provide some answers.
The OCTANE-1 trial was conducted in sub-Saharan Africa and involved 241 HIV-infected women with CD4 counts <200 cells/mm3 who had received single-dose nevirapine at least 6 months before enrollment (median, 17 months). The women were randomized to receive tenofovir/FTC plus either nevirapine or lopinav…