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Single-dose nevirapine (sd-NVP) during labor is often used in resource-poor settings to prevent maternal transmission of HIV to infants. However, sd-NVP can select for drug-resistant HIV, and many have wondered whether this treatment might compromise subsequent responses to NVP-based antiretroviral therapy (ART) in women or their infants. Now, investigators have studied the response to NVP-based ART among 218 women and 30 infants in Botswana who had previously received sd-NVP or placebo during labor (the women) or soon after delivery (the infants). The women had also received zidovudine from 34 weeks’ gestation through delivery.
By 6 months after ART initiation, 18% of the women who had received sd-NVP showed virologic failure, compared with…