Development Of Nevirapine Resistance In Infants Is Reduced By Use Of Infant-Only Single-Dose Nevirapine Plus Zidovudine Postexposure Prophylaxis For The Prevention Of Mother-To-Child Transmission Of Hiv-1

We analyzed the development of nevirapine ( NVP) resistance in human immunodeficiency virus type 1 ( HIV-1)-infected Malawian infants who received regimens containing singledose NVP ( SD-NVP) for the prevention of mother-to-child transmission ( MTCT) of HIV-1. All infants received SD- NVP, and some randomly received zidovudine ( ZDV) as well. Mothers did or did not receive SD- NVP on the basis of when they arrived at the hospital for delivery. In infants 6 - 8 weeks of age, NVP resistance was less frequent when infants had received SD- NVP plus ZDV and mothers had not received SD- NVP than when infants had received SD- NVP alone and mothers had received SD- NVP ( 4/15 [ 27%] vs. 20/23 [ 87%]; P < .001). The risk of MTCT of HIV- 1 was comparable with these regimens. Infant-only prophylaxis also eliminates the development of NVP resistance in mothers.