26/03/2004

Wrong drugs used for HIV+ African women

AIDS experts said that a drug commonly used in Africa to prevent HIV transmission from pregnant women to their babies could be harmful, according to a report in the British newspaper The Guardian.

Italian NGO Sant�Egidio said in mid-March that providing the anti-retroviral drug Nevirapine to pregnant women -- instead of administering it in combination with other medications -- left too many babies born with HIV, did not extend the mothers' lives and was responsible for spreading resistance to other anti-AIDS drugs.

In many developing countries, Nevirapine -- also called Viramune -- is administered in two oral doses -- the first to the mother during labour and the second to the new-born within 72 hours of birth to reduce the chance of HIV-positive mothers passing the virus to their children.

Its use in a combination "cocktail" with other anti-retroviral drugs such as AZT and 3TC is not contested.

Health workers in Africa value Nevirapine as one of the few easy and relatively cheap ways to prevent the spread of HIV in environments with poor medical facilities.

Nevirapine�s manufacturer, Boehringer Ingelheim, provides the drug free to public hospitals in low-income countries.

Sant�Egidio spokesman Mario Mazarriti told The Guardian Nevirapine too many babies contracted HIV regardless, and mothers' lives were not extended.

He said the drug provided no benefit for babies of about 15 percent of mothers infected with a resistant HIV strain, and administering the single-use dose could spread the Nevirapine-resistant strain and undermine combination therapy.

Mazarriti told The Guardian that HIV-positive expectant mothers should instead be given combined therapy months before giving birth.

Sant�Egidio said 97 percent of babies whose mothers received the triple treatment in its projects in Mozambique did not contract the virus.

The U.S.-based NGO AIDS Treatment Data Network also says that Nevirapine can cause resistance to some other AIDS drugs and is most effective when used in combination drug therapy.

However, James McIntyre, director of perinatal HIV research at University of Witwatersrand in Johannesburg, disagreed with Sant�Egidio�s warnings.

The Guardian quoted him saying that calls to drop Nevirapine were well-meaning but na�ve, since putting all infected pregnant women on triple therapy was not affordable.

Three months of triple therapy for one expectant mother would cost clinics in Africa about 100 pounds ($180), The Guardian said.

Kristina Hickman