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March 2002, Vol 92, No. 3 | American Journal of Public Health 365-366
© 2002 American Public Health Association

RESEARCH AND PRACTICE

Effect of Nevirapine Toxicity on Choice of Perinatal HIV Prevention Strategies

Jeffrey S. A. Stringer, MD, Moses Sinkala, MD, MPH, Dwight J. Rouse, MD, Robert L. Goldenberg, MD and Sten H. Vermund, MD, PhD

Jeffrey S. A. Stringer is with the Center for Research in Women's Health, University of Alabama at Birmingham, and the Center for Infectious Disease Research in Zambia, Lusaka, Zambia. Dwight J. Rouse, Robert L. Goldenberg, and Sten H. Vermund are with the Center for Research in Women's Health, University of Alabama at Birmingham. Moses Sinkala is with the Lusaka District Health Board, Zambian Ministry of Health, Lusaka.

Correspondence: Requests for reprints should be sent to Jeffrey S. A. Stringer, MD, Center for Infectious Disease Research in Zambia, 9965 Makanta Close, Fairview, Lusaka, Zambia (e-mail: stringer{at}uab.edu).

Objectives. This study evaluated the validity of concerns about the toxicity of nevirapine (NVP) that have delayed its implementation as a perinatal HIV prevention strategy.

Methods. A decision analysis model compared 3 strategies: single-dose NVP, short-course zidovudine (ZDV), and no intervention.

Results. NVP would prevent more deaths than ZDV and no intervention as long as the rate of NVP toxicity did not exceed, respectively, 9 times that observed in the earlier NVP clinical trial and 42 times that observed in the clinical trial. NVP would be economically preferable to ZDV as long as the rate of toxicity did not exceed 22 times that observed in the clinical trial.

Conclusions. Field implementation of NVP should not be delayed by concerns about its toxicity. (Am J Public Health. 2002;92:365–366)






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