HIV-infected children exposed in the womb to nevirapine, a drug used to prevent mother-to-child HIV transmission, can safely and effectively transition to efavirenz, a similar drug recommended for older children and adults, according to a study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health.
Efavirenz is used as part of HIV therapy for adults and children older than 3 years of age. A different class of anti-HIV drugs, lopinavir/ritonavir, is recommended for infants and young children. Switching children to efavirenz offers several advantages, including once-daily dosing, easier storage, better taste, and lower cost. Prior to the new study, however, doctors lacked guidance on when to switch to efavirenz. There also was concern that efavirenz may be less effective in children exposed to nevirapine because the drugs attack HIV in similar ways, leading to potential drug resistance.
Researchers led by Louise Kuhn, PhD, of Columbia University, conducted a randomized clinical trial in Johannesburg, South Africa, to evaluate whether or not nevirapine-exposed children, who have their infection under control, can transition to efavirenz without risk of the virus rebounding and becoming detectable in blood. Approximately 300 boys and girls at least 3 years old were followed for 48 weeks, with half continuing on lopinavir/ritonavir and the other half switching to efavirenz.
The team found that both groups of children had similar rates of viral rebound--26 in the efavirenz group and 42 in the lopinavir/ritonavir group, suggesting that switching to efavirenz is effective. Furthermore, the efavirenz group had higher levels of CD4 T cells, key immune cells wiped out by HIV, and better liver function, suggesting that efavirenz is less toxic and safer than lopinavir/ritonavir. The researchers are currently conducting a follow-up study to evaluate the long-term effects of switching to efavirenz.
Source: NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development
A Helping Hand: Innovative Approaches to Expanding Hand Hygiene Programs in Acute Care Settings
July 9th 2025Who knew candy, UV lights, and a college kid in scrubs could double hand hygiene adherence? A Pennsylvania hospital’s creative shake-up of its infection prevention program shows that sometimes it takes more than soap to get hands clean—and keep them that way.
Broadening the Path: Diverse Educational Routes Into Infection Prevention Careers
July 4th 2025Once dominated by nurses, infection prevention now welcomes professionals from public health, lab science, and respiratory therapy—each bringing unique expertise that strengthens patient safety and IPC programs.
How Contaminated Is Your Stretcher? The Hidden Risks on Hospital Wheels
July 3rd 2025Despite routine disinfection, hospital surfaces, such as stretchers, remain reservoirs for harmful microbes, according to several recent studies. From high-touch areas to damaged mattresses and the effectiveness of antimicrobial coatings, researchers continue to uncover persistent risks in environmental hygiene, highlighting the critical need for innovative, continuous disinfection strategies in health care settings.