What is AIDS?
AIDS is a disease caused by a virus. The virus, called HIV (human immunodeficiency virus) gets into the cells that protect the body from disease. Once it has entered these cells, it uses them to make more copies of itself. This weakens your body's protection against diseases. Over time, this can lead to sickness.
What is nevirapine?
Nevirapine is a drug that makes it harder for HIV to make more copies of itself. When you take nevirapine, the amount of virus in your body goes down. This means that there is less chance of passing the virus to your new child.
How is nevirapine used?
Nevirapine can be used along with other drugs to fight HIV. By itself, nevirapine will not totally stop HIV from multiplying. It should be used together with other drugs that fight HIV.
Nevirapine is also used to protect a new baby from getting HIV from its mother. This is called mother-to-child transmission or MTCT. If the mother takes just one tablet of nevirapine when she starts having labor pains, and if the new baby takes one dose of nevirapine, the risk of the baby getting HIV from its mother is cut in half. This dose does not help the health of the woman. It only helps stop the transmission to the baby.
When does mother-to-child transmission happen?
HIV can be passed from mother to baby
If a mother passes HIV to her new child, it usually does not happen during pregnancy. It happens most often when the baby is being born, from the mother's blood, and during breastfeeding, since HIV is also found in breast milk.
How does nevirapine prevent the new child from getting HIV?
When a pregnant woman takes nevirapine, the amount of virus in her body goes down. That means that while the baby is being born, there is less virus in the mother's blood that could pass on to the child. A pregnant woman must take her nevirapine tablet as soon as her labor pains begin. She can take it at home. She should not wait until she gets to the clinic or hospital. It's important to give the drug a chance to fight the virus for a few hours before the baby is born. When the baby is born, it is given its own dose of nevirapine within 72 hours. The baby's dose is usually in a liquid form. This helps the baby fight HIV, in case some virus was passed from the mother.
Nevirapine can help prevent a mother passing HIV to her child at the time it is born. However, if a mother has HIV and she breast-feeds her baby, the baby can still get HIV.
How can you tell if the new baby has HIV?
It takes eighteen months to find out if an infant is infected with HIV. That is because every child born to a mother with HIV will carry some of the mother's protection against HIV. The HIV test looks for signs of this protection, called antibodies. If the baby doesn't have HIV, the protection will fade by 12 to 18 months time. If the baby does have HIV, it will start making its own protection. When the baby is 18 months old, an HIV test can tell you if your baby has HIV or not.
Remember, if you breastfeed your infant, you can pass HIV to your baby even if they were not infected at birth. Doctors and nurses at your clinic or hospital should tell you about your other choices for feeding your new baby.
Does nevirapine cause any problems when you take it?
Thousands of women and new babies have taken nevirapine without any problems at all. Taking just one dose does not make women sick and it does not make their babies sick. It helps protect babies from being born HIV-positive.
If you take many doses of nevirapine, it can make you feel sick. This is a sign of how strong the drug is. You should know about these "side effects" so that you can tell your nurse or doctor about them and share the information with your community.
If you are taking drugs every day to control HIV, they might make you feel ill. This can mean nausea, vomiting or diarrhea, especially in the first week or two when you take the drugs. Some woman who are taking nevirapine can get a rash. The rash goes away in a few weeks. Nevirapine can also give you trouble with your liver, the organ inside you that helps clean your blood. In some cases this is serious. A single does of nevirapine should not cause any of these serious side effects for you or your baby.
If you or your baby can take drugs against HIV every day, you may have some of these side effects. If you do, tell your doctor or nurse. Do not stop taking the drugs without talking to him or her first. But sometimes the side effects could get very serious before you can go to the hospital or clinic. If this happens, you should stop taking all of your HIV pills and wait to have a clinic visit before you start them again.
Do I have to take all the pills the doctor gives me?
If you have side effects, you might want to stop taking all your pills. This is not a good idea. HIV can change its shape so that the drugs that fight it lose their power. This is called resistance. The more HIV can multiply, the more chance it will become resistant. Over a short period of time, like labor, one drug can stop HIV and protect against transmission. Over weeks and months, one drug is not strong enough to stop HIV from making more copies of itself. If you take drugs to fight HIV every day, it is always best to take two or more drugs. No drug is strong enough to stop HIV by itself. Taking two or more drugs is the best way to fight the virus.
Even if you take just one dose of nevirapine, your HIV might become resistant. If that happens, nevirapine may not be as strong against the virus the next time you use it. This does not mean that it will not work again during pregnancy. You can still probably use one dose of nevirapine the next time you have a child. But nevirapine may not be a strong weapon against your own virus if you start treatment for yourself. Babies who take medications against HIV for many months or years of their lives may need other drugs besides nevirapine and others like it to fight the virus. Also, even if your virus or your baby's becomes resistant to nevirapine, this will not change how drugs work against malaria, TB or any other diseases.
* This fact sheet was created by women's health advocates in South Africa and the United States, and reviewed for accuracy by James McIntyre, an obstetrician in Soweto, South Africa.
