Catherine you wrote, "Most studies of neviripine in infants to prevent MTCT
of HIV are done with a single dose.  Many frequently used drugs can cause liver
failure,
including depakote/valproate, which has become one of the first line
drugs for childhood seizures.  We certainly need safer drugs.

I know that nevirapine (viramune) is single dose for MTCT of HIV. I find it
ironic that a full-grown adult (health care worker) will be cautioned about its
use because of the potential of liver failure (one health care worker's liver
failed within two weeks).  Giving one dose to a newborn infant, maybe as
risky.  The NIH medline on this drug states that children are more sensitive, more
likely to get granulocytopenia than adults on this drug.  Because newborn
testing of HIV is difficult to determine accurately, there will be some infants
who will be treated with this highly toxic drug unnecessarily.  Unlike a child
has been diagnosed with seizures (not presumed to have seizures), the infant
who is presumed to have HIV, maybe taking a very toxic drug for a disease they
don't have(and of course discouraged from breastfeeding increasing their risks
of infections and hospitalizations).
Yes, I totally agree we have to have safer drugs.
Valerie W. McClain, IBCLC



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