South Africa will continue providing Nevirapine as monotherapy to mothers and babies

Aug 17 2004

The South African Government's policy to reduce the risk of mother to child transmission of HIV, remains unchanged. The Department of Health will continue providing Nevirapine as monotherapy to mothers and babies at public health facilities until new agreed upon treatment regimens are available.

A consultative workshop will be held after the International Aids Conference that is being held in Bangkok, Thailand, to revisit the treatment protocols for the Prevention of Mother To Child Transmission of HIV (PMTCT) programme.

This follows the Medicines Control Council's (MCC's) recommendation that a combination of anti-retrovirals be used instead of a single dose of Nevirapine (monotherapy) for PMTCT. It must be emphasised that the MCC did not recommend that the use of Nevirapine be stopped altogether, but that it should be used in combination with other drugs, because it is showing a significant resistance of up to 50%. Also, the drug has not been deregistered as indicated in media reports.

The MCC's findings are in line with a recent World Health Organisation's recommendation, which stated that combination therapy using both AZT and Nevirapine is the preferred approach (to monotherapy) for PMTCT.

There are concerns among researchers that a regimen of single dose Nevirapine can cause resistance in HIV infected mothers and infants. Viral resistance to Nevirapine is mostly found in women with high viral loads and low CD4 counts.