Clinical

Nevirapine toxicity uncommon in pregnant women

Last Updated: 2006-01-31 11:20:27 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Most HIV-positive pregnant women taking an antiretroviral regimen containing nevirapine show no ill effects from the agent, Brazilian researchers report in the January issue of the American Journal of Obstetrics and Gynecology.

Dr. Esau Custodio Joao and colleagues at Hospital dos Servidores do Estado, Rio Janeiro note that nevirapine "is easy to take, well tolerated and inexpensive. It is widely used in Brazil as part of a 3-drug regimen during pregnancy." However, they add that there have been a few reports of serious and even fatal side effects.

To investigate, the researchers conducted a retrospective study of 197 women who started nevirapine after becoming pregnant and who used the agent for more than 7 days.

Toxicity was seen in 11 patients (5.6%). This led to drug discontinuation in 7. There was 1 case of Stevens-Johnson syndrome and 1 of grade 4 cholestasis.

Hepatitis C virus (HCV) was significantly associated with toxicity. HCV infection was seen in 3 (27%) of these patients. This was true of only 4.2% of the women without signs of toxicity.

The researchers observe that toxic side effects were apparent in only a "very small" fraction of patients and there were no fatalities.

"The strongest predictor of nevirapine toxicity in this study was the evidence of anti-HCV antibodies," Dr. Joao told Reuters Health. "Thus, screening of all pregnant women for hepatitis B and HCV should be conducted whenever nevirapine use is considered."

Am J Obstet Gynecol 2006;194:199-202.