Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
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Associated Press (12.16.04) - Friday, December 17, 2004
Geoffrey Muleme
South Africa's Treatment Action Campaign warned that reopening debate about the Uganda nevirapine study could discourage patients from the treatment, even though subsequent research has confirmed nevirapine is safe and effective. "I use [nevirapine] twice daily," said Zackie Achmat, TAC's leader.
Doctors in the country's public-health system have privately expressed fears that they will be pressured to stop supplying the single-dose nevirapine therapy to pregnant women before alternative drugs are available. Until this year, the government of President Thabo Mbeki had refused to supply antiretrovirals through the public-health system, citing concerns over cost and safety. In July, a South African regulator recommended halting the single-dose nevirapine regimen for pregnant women, saying a drug cocktail should be used instead. Such drugs, however, are expensive and available chiefly in the United States and other developed nations.
The Health Department said Wednesday that US concerns about the Uganda research support its cautious approach. The department is reviewing its guidelines on mother-to-child transmission, but the drug is still being distributed by hospitals, said spokesperson Sibani Mngadi.
According to studies, a single nevirapine dose to a woman in labor and to her newborn can cut the risk of HIV transmission by up to 50 percent. In some patients, daily use of nevirapine can cause rashes, liver toxicity and death. No serious reactions have been found after a single dose, but a South African study said 39 percent of HIV-infected women who get the single dose go on to harbor virus that is resistant to the drug.
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