Extended prophylaxis with nevirapine and cotrimoxazole among HIV-exposed uninfected infants is well tolerated

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dc.contributor.authorAizire, Jim
dc.contributor.authorFowler, Mary Glenn
dc.contributor.authorWang, Jing
dc.contributor.authorShetty, Avinash K.
dc.contributor.authorChibanda, Lynda Stranix
dc.contributor.authorKamateeka, Moreen
dc.contributor.authorBrown, Elizabeth R.
dc.contributor.authorBolton, Steve G.
dc.contributor.authorMusoke, Philippa M.
dc.contributor.authorCoovadia, Hoosen
dc.date.accessioned2022-01-31T14:05:40Z
dc.date.available2022-01-31T14:05:40Z
dc.date.issued2012
dc.description.abstractNevirapine and cotrimoxazole are associated with hematologic toxicities and skin-rash. Safety of their concurrent use for prophylaxis over extended periods among HIV-exposed uninfected infants has not been previously assessed.Secondary data analysis of the ‘HIV Prevention Trials Network-046 protocol’ (version 2.0), a phase-III, randomized, placebo-controlled trial that assessed efficacy and safety of nevirapine prophylaxis against breast milk transmission of HIV-1.Trial infants received 6-month study nevirapine/placebo, and standard-of-care peripartum single-dose nevirapine+/– zidovudine ‘tail’, and cotrimoxazole prophylaxis from 6 weeks through breastfeeding cessation. Adverse events were monitored using United States Division of AIDS Toxicity Tables (2004). Risk of neutropenia, anemia and skin-rash in the cotrimoxazole+nevirapine and the cotrimoxazole+placebo groups were compared using negative-binomial regression.Incidence of neutropenia and/or anemia, and skin-rash was highest during the first 6 weeks of life and declined, thereafter, regardless of study group. Time to first adverse event after 6 weeks was similar in cotrimoxazole+nevirapine and cotrimoxazole+placebo groups: hazard ratio (95% confidence interval) was 1.26 (0.96–1.66) for neutropenia and/or anemia (all grades), 1.27 (0.80–2.03) for neutropenia and/or anemia (grade ≥3) and 1.16 (0.46–2.90) for skin-rash (grade ≥2). There were no statistically significant differences in immediate (6 weeks–6 months) and long-term (6–12 months) adverse event risk among infants on cotrimoxazole+nevirapine versus cotrimoxazole+placebo.Extended nevirapine and cotrimoxazole prophylaxis through 6 months of age among HIV-exposed uninfected infants did not appear to increase the immediate or long-term risk of neutropenia, anemia or skin-rash. Concurrent use beyond 6 months, however, needs to be evaluated.en_US
dc.identifier.citationAizire, J., Fowler, M. G., Wang, J., Shetty, A. K., Stranix-Chibanda, L., Kamateeka, M., ... & Coovadia, H. (2012). Extended prophylaxis with nevirapine and cotrimoxazole among HIV-exposed uninfected infants is well tolerated. AIDS (London, England), 26(3), 325.doi: 10.1097/QAD.0b013e32834e892cen_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1680
dc.language.isoenen_US
dc.publisherAIDS (London, England)en_US
dc.subjectanemia, cotrimoxazole, HIV-exposed uninfected infants, neutropenia, nevirapine, skin-rashen_US
dc.titleExtended prophylaxis with nevirapine and cotrimoxazole among HIV-exposed uninfected infants is well tolerateden_US
dc.typeArticleen_US
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