Nevirapine is effective
In February's issue you included an article and comment
concerning the use of Viramune (nevirapine) in the prevention of mother-to-child
transmission of HIV.
The advantages of the regimen are that it is very easy to give in a resource
poor setting, and is very well tolerated. It prevents approximately 50
per cent of infections in infants that would otherwise occur (data from
public US website: www.hivatis.org). The Viramune Donation Program, which
started in July 2000, will provide treatment for 72,000 mothers and children
in 23 countries.
These mothers are not being given a second rate treatment. For HIV infected
women who are in labour and who have had no prior therapy, the US Public
Health Service Task Force include a dose of Viramune to the mother and
to the newborn at 48 hours as an effective regimen.
You mention AZT/3TC as alternatives to Viramune in MTCT. Although effective,
these agents are not without their own problems of resistance and toxicity
- see page 213 of the National Aids Manual 2001 for a good summary.
The advice in the UK is when using Viramune, to combine it with two other
agents, such as AZT/3TC, to minimise the development of resistance.
Kevin Curry, Senior Medical Adviser, Boehringer
Ingelheim UK
Praise from Colombia
I am an HIV positive man living in southern Colombia with my partner.
He is positive also and received the very best care from St Thomas's Hospital,
London when he was very poorly last year. HIV and Aids is brought out
so much more into the open in
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the UK than in Colombia. Here there are no HIV awareness programmes or
