@article{fdi:010057350,
  title = {{L}ong-term outcome of nevirapine or efavirenz based antiretroviral regimens in mothers exposed to single dose nevirapine},
  author = {{S}ripan, {P}. and {N}go-{G}iang-{H}uong, {N}icole and {T}raisathit, {P}. and {C}hutanunta, {A}. and {L}uekamlung, {N}. and {L}ertkoonalak, {R}. and {B}uranawanitchakorn, {Y}. and {B}anchongkit, {S}. and {C}ressey, {T}. {R}. and {L}e {C}oeur, {S}ophie and {L}allemant, {M}arc and {J}ourdain, {G}onzague},
  editor = {},
  language = {{ENG}},
  abstract = {{E}xposure to single dose nevirapine during labor ({SD}-{NVP}) to prevent mother to child transmission of {HIV} ({PMTCT}) is associated with a lower likelihood of virologic suppression at six months of a nevirapine based antiretroviral therapy but long-term consequences of {SD}-{NVP} have not been studied. {W}e analyzed data from women who received {SD}-{NVP} in the {PHPT}-2 {PMTCT} clinical trial. {F}ollowing delivery, women initiated a regimen composed of nevirapine, lamivudine, and stavudine or zidovudine when their {CD}4 level declined to less than 250 cells/mm(3). {HIV} {RNA} load and {CD}4 cell counts were evaluated every six months. {F}ailure was defined as a confirmed {HIV} {RNA} load > 400 copies/m{L} at least 6 months after therapy initiation, or death, and observations were censored at time of drop out or switch to a protease inhibitor based regimen. {S}urvival analysis was performed using {K}aplan-{M}eier estimates and {C}ox regression models. {T}he 221 {SD}-{NVP} exposed women and 48 unexposed women had similar characteristics at baseline, except the time spent between delivery and initiation of therapy (6.1 and 14.9 months, respectively). {A}t four years, 35% of the {SD}-{NVP} exposed and 14% of the unexposed women met the failure criteria ({P}=0.02). {I}n the multivariable analysis, factors contributing to the failure consisted of exposure to {SD}-{NVP} ({HR}: 2.63, {P}=0.03), plasma {HIV}-1 {RNA} level above median ({HR}: 2.53, {P}<0.001), stage {C} of the {CDC} {HIV} clinical staging ({HR}: 2.12, {P}=0.04), platelets cell count above median ({HR}: 1.65, {P}=0.04) and early initiation of therapy after delivery ({HR}: 1.64, {P}=0.04). {I}n this cohort, the impact of {SD}-{NVP} on further antiretroviral therapy was still significant after four years of therapy, justifying the use of strategies to prevent resistance mutations after exposure to {SD}-{NVP}.},
  keywords = {{H}uman {I}mmunodeficiency {V}irus, single dose nevirapine ; antiretroviral treatment ; long-term outcome ; mother to child transmission of {HIV}},
  booktitle = {},
  journal = {{C}hiang {M}ai {J}ournal of {S}cience},
  volume = {39},
  numero = {4},
  pages = {660--668},
  ISSN = {0125-2526},
  year = {2012},
  URL = {https://www.documentation.ird.fr/hor/fdi:010057350},
}