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Nevirapine Concentrations in Preterm and Low Birth Weight HIV-Exposed Infants: Implications for Dosing Recommendations

de Waal, Reneé MBChB*; Kroon, S. Max MBChB, FCPaed; Holgate, Sandi L. MBChB, FCPaed; Horn, Alan R. MBChB, FCPaed, PhD; Tooke, Lloyd J. MBChB, MMed, FCPaed; Norman, Jennifer MSc*; Smith, Peter PhD*; Blockman, Marc MBChB, BPharm, MMed*; Cotton, Mark F. MMed, FCPaed, PhD; McIlleron, Helen M. MBChB, PhD*; Cohen, Karen MBChB, MMed, MSc*

Pediatric Infectious Disease Journal: December 2014 - Volume 33 - Issue 12 - p 1231–1233
doi: 10.1097/INF.0000000000000453
HIV Reports

World Health Organisation guidelines recommend nevirapine 2 mg/kg/d for HIV-exposed infants <2 kg, but 4–6 mg/kg/d for infants >2 kg. In 116 low birth weight infants, nevirapine 2 mg/kg/d until 14 days, and 4 mg/kg/d thereafter, was safe (1 mild possibly related rash) and achieved target plasma concentrations. Concentrations decreased with treatment duration. Routine dose increase at 14 days should be considered.

From the *Division of Clinical Pharmacology, Department of Medicine, and Department of Paediatrics, University of Cape Town, Cape Town; and Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa.

Accepted for publication May 14, 2014.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Karen Cohen, MBChB, MMed, MSc, Division of Clinical Pharmacology, K45 Old Main Building, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa. E-mail: karen.cohen@uct.ac.za.

© 2014 by Lippincott Williams & Wilkins, Inc.