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A study was conducted to examine the different effective strategies that can be implemented to reduce mother-to-child transmission of HIV-1 through breast feeding. Results indicated that extended prophylaxis with nevirapine or nevirapine with zidovudine was effective in significantly reducing HIV-1 infection

The clinical and immunologic effectiveness and acute toxicity to nevirapine (NVP)-based fixed-dose combinations (FDCs) in antiretroviral-native HIV-1 infected patients in India is studied. Fixed-dose formulations of NVP-based combination therapy are safe and produced durable clinical and immunologic benefit.

An open-label, observational, prospective 18-month survey is conducted to compare the efficacy and tolerability of efavirenz and nevirapine, the two-nonnucleoside reverse transcriptase inhibitors (NNRTIs) in all-possible indication available in current clinical practice. A limited virologic and immunologic advantage of efavirenz was observed in the first 12-month assessment of antiretroviral-naive patients, whereas all other examined situations did not disclose relevant efficacy differences.

Nevirapine and efavirenz may be more effective AIDS drugs than abacavir, according to a study of 460 HIV patients. These drugs are often used instead of protease inhibitors because protease inhibitors have serious side effects. In this study, abacavir seemed to have fewer side effects than the other two drugs.

Pregnant women with HIV infection do not need to take nevirapine if they are already taking zidovudine or other AIDS drugs. These drugs are used to prevent the virus from passing to the baby during childbirth. In a study of 1,170 women, nevirapine did not lower the risk of transmission more than traditional AIDS drugs do., Context: A 2-dose intrapartum/newborn nevirapine regimen reduced perinatal human immunodeficiency virus (HIV) transmission in Ugandan women not receiving antenatal antiretroviral therapy (ART). However, it is unknown whether the addition of the 2-dose nevirapine regimen to standard ART would further reduce perinatal HIV transmission. Objective: To determine whether a 2-dose nevirapine regimen can decrease perinatal transmission of HIV in nonbreastfeeding women receiving standard ART. Design and Setting: International, blinded, placebo-controlled, phase 3 trial enrolling women between May 1997 and June 2000 at clinical sites providing care for HIV infection throughout the United States, Europe, Brazil, and the Bahamas. Participants: A total of 1270 women received nevirapine (n=642) or placebo (n=628). Infants were followed up for 6 months to determine HIV-infection status, which was available for 1248 deliveries. Intervention: A 200-mg dose of oral nevirapine to women after onset of labor and a 2-mg/kg dose of oral nevirapine to newborns between 48 and 72 hours after birth. Main Outcome Measures: Detection of HIV infection in infants and grade 3 and 4 toxic effects in women and newborns. Results: After review by the data and safety monitoring board, the trial was stopped early because the overall transmission rates were significantly lower than assumed for the study design. Antenatal ART included zidovudine alone in 23%; combinations without protease inhibitors in 36%; and combinations with protease inhibitors in 41%. Thirty-four percent of women had elective cesarean delivery. No significant safety concerns were identified for women or infants. Detection of HIV infection occurred in 9 (1.4%; 95% confidence interval [CI], 0.6%-2.7%) of 631 nevirapine group deliveries and 10 (1.6%; 95% CI, 0.8%-2.9%) of 617 placebo group deliveries. The 95% CI for the difference in transmission rate (-0.2) between the 2 study arms ranged from -1.5% in favor of nevirapine to 1.2% in favor of placebo (P=.82, Fisher exact test). The transmission rate was higher in women with lower baseline CD4 cell counts and higher delivery HIV RNA levels, but there was no significant difference between treatment arms in any sub group. Conclusion: Risk of perinatal HIV transmission was low and no benefit from additional intrapartum/newborn nevirapine was demonstrated when women received prenatal care and antenatal ART, and elective cesarean section was made available.

The non-nucleoside reverse transcriptase inhibitors nevirapine or efavirenz appear to be effective in treating HIV patients who develop psychomotor disorders that are a sign of early AIDS dementia. This was the conclusion of a study of 170 AIDS patients who were also taking nucleoside reverse transcriptase inhibitors.

Study has shown that rifampicin reduces serum exposure to nevirapine, but clinical implications are yet to be established. Pharmacokinetic interaction between nevirapine and rifampicin has been studied in HIV-infected patients with tuberculosis. The steady-state serum pharmacokinetics (PKs) of nevirapine before and during treatment with rifampicin and the steady-state serum PKs of rifampicin in patients receiving rifampicin alone or in combination with nevirapine are reported.

Switching AIDS therapy from a combination of drugs that includes a protease inhibitor to one that includes nevirapine may benefit HIV patients with fat metabolism disorders caused by protease inhibitors. In a study of 106 HIV patients who switched, cholesterol levels decreased, but changes in body composition remained the same.