Abstract
To the editor—I would like to point out a factual error in your editorial "Uganda gives lessons in stemming the AIDS epidemic" in the September issue of Nature Medicine. The third paragraph states that the HIVNET 012 trial showed that a regimen of nevirapine "is almost twice as effective at reducing vertical transmission as the AZT regimen tested in Thailand last year...."
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In fact, the HIVNET 012 trial compared nevirapine to a very different regimen of AZT. The regimen used in the Thai trial was 300 mg twice daily beginning at 36 weeks of gestation and 300 mg every 3 hours during labor1. The regimen used in the HIVNET trial in Uganda was 600 mg at the onset of labor, 300 mg every 3 hours during labor, and 4 mg/kg twice a day to children for 7 days2. Thus, the Thai AZT regimen mainly targeted the mother and most likely acts to reduce maternal viral load, whereas the HIVNET 012 regimen mainly targeted the child and most likely acts as post-exposure prophylaxis. The nevirapine regimen used in the HIVNET 02 trial has not been compared with the AZT regimen used in the Thai trial in any studies.
As you know, many countries are now considering perinatal HIV intervention programs and might be misled or confused by this error.
References
Shaffer, N. et al. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Lancet 353, 773–780 (1999).
Guay, L.A. et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 354, 795–802 (1999).
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Simonds, R. AIDS drug trials in Thailand and Uganda. Nat Med 5, 1217 (1999). https://doi.org/10.1038/15148
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DOI: https://doi.org/10.1038/15148
