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In SA guidelines prior to 2010, the recommended second-line ART regimen for children or adolescents failing PI-based first-line ART was an NNRTI plus two NRTIs.
These second- or third-line regimens following PI-based ART usually include integrase strand transfer inhibitors (INSTIs), a PI (older or new generation) and possibly an NNRTI (new generation).
The prevalence of NNRTI DRM found in the present study (11.
21 The current preferred first-line antiretroviral therapy(ART) regimens include two NRTIs with either a NNRTI or a PI/r.
In general, schemes that use two NRTIs + NNRTI dosage is simpler, which probably facilitates adherence to treatment.
NNRTI treatment should be stopped immediately in anyone presenting with a rash and systemic symptoms.
In this pilot study of women treated with Sd-NVP, one-third had a detectable NNRTI resistance mutation at 1 month after delivery.
There is no place for maintaining patients failing an NNRTI regimen on the same regimen; the longer it is maintained, the more resistance mutations are likely to occur.
This trial tested TMC125 in volunteers who had received an NNRTI (usually efavirenz or nevirapine) and had at least one resistance mutation to it.
New precautions are added to the labeling for the NNRTI nevirapine (Viramune).
TMC125-also known as R165335, this promising new NNRTI may become one of the first drugs in this class to beeffective against NNRTI-resistant virus.
An exception is in patients requiring treatment with regimens that preclude NNRTI or protease inhibitor use.
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