摘要：Objectives. This study evaluated the validity of concerns about the toxicity of nevirapine (NVP) that have delayed its implementation as a perinatal HIV prevention strategy. Methods. A decision analysis model compared 3 strategies: single-dose NVP, short-course zidovudine (ZDV), and no intervention. Results. NVP would prevent more deaths than ZDV and no intervention as long as the rate of NVP toxicity did not exceed, respectively, 9 times that observed in the earlier NVP clinical trial and 42 times that observed in the clinical trial. NVP would be economically preferable to ZDV as long as the rate of toxicity did not exceed 22 times that observed in the clinical trial. Conclusions. Field implementation of NVP should not be delayed by concerns about its toxicity. (Am J Public Health. 2002;92:365–366) A single dose of nevirapine (NVP) given to an HIV-infected mother at labor onset, followed by a dose given to the infant after delivery, significantly reduces perinatal HIV transmission. 1 However, concerns have been raised over possible toxicity arising from widespread use of the drug. 2 Given NVP's high degree of efficacy and its favorable cost-effectiveness relative to interventions involving zidovudine (ZDV), 3 we sought to characterize, in this study, the magnitude of toxicity that would be required for its known benefits to be outweighed by any as yet unrealized detrimental effects.
