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• W2127583738 abstract "Nevirapine is widely used in the developing world for the prevention of mother-to-child transmission (PMTCT) of HIV. A single mutation in the HIV genome is sufficient to lead to significant nevirapine resistance. Persistence of low-level drug concentrations in body compartments can foster resistance formation. In this study, concentration–time courses of nevirapine after single-dose administration were analysed over an extended post-partum period. Breast milk and plasma samples of 62 HIV-positive Ugandan mother–child pairs who had received single-dose nevirapine were collected at delivery and 1, 2 and 6 weeks post-partum. Nevirapine concentrations were quantified by LC/tandem-mass-spectrometry using a quantification limit of 15 ng/mL, and a population pharmacokinetic (PK) analysis was performed. Concentration–time profiles in breast milk, maternal plasma and child plasma showed similar shapes. At week 1, median nevirapine concentrations were 164 ng/mL in maternal plasma, 114 ng/mL in breast milk and 183 ng/mL in child plasma. The population PK model predicted nevirapine concentrations >10 ng/mL (IC50 for nevirapine) for 13 days in breast milk, 14 days in maternal plasma and 18 days in child plasma in 80% of the samples. Nevirapine concentrations were present for 2–3 weeks in the three compartments. The concentrations are probably sufficiently high to protect most breastfed children from HIV transmission during the first 2 weeks. The long presence of slowly decreasing levels of nevirapine is likely to induce resistance formation. Post-natal addition of antiretrovirals for 1 week only, as recommended in the current PMTCT guidelines, will not suffice to avoid nevirapine resistance formation." @default.
• W2127583738 created "2016-06-24" @default.
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• W2127583738 date "2008-10-18" @default.
• W2127583738 modified "2023-10-16" @default.
• W2127583738 title "Persistence of nevirapine in breast milk and plasma of mothers and their children after single-dose administration" @default.
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• W2127583738 doi "https://doi.org/10.1093/jac/dkn441" @default.
• W2127583738 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/18974161" @default.
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