Babies: the first humans to take PrEP

PrEP has, in fact, been tried successfully in humans, in the shape of that most vulnerable of populations, newborn babies. In prevention of mother-to-child transmission (PMTCT) regimes that use single-dose nevirapine (Viramune), the drug is in fact working not by suppressing HIV in the mother, which would require repeated doses of combination therapy, but by crossing the placental barrier and acting as prophylaxis in the foetus.

However, in addition to this, in many PMTCT studies babies have been given antiretrovirals after birth. This effectively represents PrEP for infants against HIV transmission through breast milk.

The SIMBA trial in Southern Africa, for instance, gave AZT (zidovudine, Retrovir) and ddI (didanosine, Videx) to the mothers from 36 weeks of pregnancy to one week after giving birth.1

It then gave nevirapine or 3TC (lamivudine, Epivir) to the babies from birth till four weeks after weaning, with the mothers committing to breastfeed for only six months.

The ‘late transmission rate’ in babies (meaning infection from four weeks to six months after birth) was only 1%, compared with a usual rate of around 9%, thus reflecting a PrEP efficacy in this case of around 80%.

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References

  1. Vyankandondera J et al. Reducing risk of HIV-1 transmission from mother to infant through breastfeedingusing antiretroviral prophylaxis in infants (Simba study). Second International AIDS Society Conference on HIV Pathogenesis and Treatment, Paris, abstract LB7, 2003
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.