Aizire, JimMcConnell, Michelle S.Mudiope, PeterMubiru, MichaelMatovu, FlaviaParsons, Teresa L.Elbireer, Ali ,Nolan, MonicaJanoff, Edward N.Glenn Fowler, Mary2023-06-212023-06-212012Aizire, J., McConnell, M. S., Mudiope, P., Mubiru, M., Matovu, F., Parsons, T. L., ... & Fowler, M. G. (2012). Kinetics of nevirapine and its impact on HIV-1 RNA levels in maternal plasma and breast milk over time after perinatal single-dose nevirapine. JAIDS Journal of Acquired Immune Deficiency Syndromes, 60(5), 483-488.https://journals.lww.com/jaids/fulltext/2012/08150/Kinetics_of_Nevirapine_and_Its_Impact_on_HIV_1_RNA.6.aspxhttps://nru.uncst.go.ug/handle/123456789/8955To determine kinetics after single-dose nevirapine and the impact on HIV RNA [viral load (VL)] in maternal plasma and breast milk (BM). Methods: Cohort of 120 HIV-1–infected pregnant Ugandan women received perinatal single-dose nevirapine alone and followed up with their infants through 24 weeks postdelivery. We assessed the relationship of nevirapine concentration (tandem mass spectroscopy) and HIV-1 VL (Roche AMPLICOR HIV-1 Kit, version 1.5) in maternal plasma and BM over time. Results: At week 1 postpartum, NVP ($10 ng/mL) was detected in all 53 plasma and 47 of 51 (92.2%) BM samples with median (inter- quartile ranges) of, respectively, 171 (78–214) ng/mL and 112 (64–158) ng/mL, P = 0.075, which decreased subsequently with traces persisting through week 4 in plasma. Plasma and BM VL dropped by week 1 and were highly correlated at delivery (R = 0.71, P , 0.001) and week 1 (R = 0.69, P , 0.001) but not thereafter. At week 1, VL correlated inversely with NVP concentra- tion in plasma (R = 0.39, P = 0.004) and BM (R = 0.48, P = 0.013). There was a VL rebound in both compartments, which peaked at week 4 to levels greater than those at week 1 [significantly in plasma (P , 0.001) but not in BM] and remained stable thereafter. Median VL was consistently greater (11- to 50-fold) in plasma than BM at all time points (all P , 0.001). Conclusions: After single-dose nevirapine, NVP concentration was comparably high through week 1, accompanied by suppression of plasma and BM VL. A longer “tail” (.1 week) of potent postnatal antiretroviral drugs is warranted to minimize the observed VL rebound and potential for NVP resistance as a result of persistent NVP tracesenNevirapineHIV-1 RNAMaternal plasmaBreast milkArticle