In one study, researchers gave either of two treatments to 241 African women who'd taken a single dose of nevirapine at least six months earlier. Twenty-six percent of those who took a regimen that included nevirapine either died or failed to beat back the virus, compared to 8 percent of those who took the other regimen. The regimens were nevirapine plus tenofovir-emtricitabine or ritonavir-boosted lopinavir plus tenofovir-emtricitabine.
In the other study, researchers tested two regimens -- zidovudine and lamivudine plus nevirapine, or zidovudine and lamivudine plus ritonavir-boosted lopinavir -- in HIV-infected babies aged 6 months to 3 years. Only about 60 percent of the babies on the nevirapine regimen managed to both beat back the virus and survive, compared to about 78 percent of the other babies.
The results in the babies were so clear that the researchers ended their study early. Another study, which hopes to determine the best treatment for infected babies who didn't get nevirapine at birth, is continuing.
Nevirapine by itself is inexpensive, but many pregnant mothers in poor countries still aren't given it to prevent transmission to their babies, said Dr. Paul E. Palumbo, lead author of the second study and director of the International Pediatric HIV Program at Dartmouth-Hitchcock Medical Center.
The cost will be a big challenge to providing the alternative regimens, both researchers say. "When you're already struggling to provide drugs and then you goose the cost dramatically by changing the regimen, it really requires a lot of creativity and problem-solving," Palumbo said. "It could take years for even the beginning of implementation, and many years before it's more comprehe
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