Preventing mother-to-child transmission of HIV
I just wrote a post for this other blog to which I contribute about the ethics of prevention of mother-to-child transmission of HIV. I am curious to hear what others think about PMTCT using Nevirapine. Because Nevirapine can create issues with drug resistance for mothers, does it not pose an ethical dilemma in treating HIV-positive pregnant women in order to decrease the chances of passing the infection to their unborn children?
Many women in resource-poor countries depend on government-run antenatal clinics, which themselves typically provide routine HIV testing (my research says it’s more mandatory than routine). The use of routine antenatal clinic testing is meant to increase opportunities to intervene with PMTCT treatment. However, by prescribing Nevirapine intrapartum and during birth, the patient runs the risk of becoming resistant to other antiretroviral therapy.
Researchers in Zambia have in press an article with the Lancet (gated) detailing their study of using alternative drug treatments for HIV-positive pregnant women. Sounds promising, but I wonder if the concern about drug resistance will be resolved with these different drugs.