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Humanized NOD/SCID/IL2rγnull (hu-NSG) Mouse Model for HIV Replication and Latency Studies
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Oral Lamivudine for Extended HIV Postnatal Prophylaxis
Philippe Van de Perre1, Nicolas Meda2, Souleymane Tassembedo3
1UMR 1058 'Pathogenesis and Control of Chronic and Emerging Infections', INSERM-Université Montpellier, Inserm ADR Languedoc-Roussillon, 60 rue de Navacelles, 34394, Montpellier Cedex 5, France. philippe.vande-perre@umontpellier.fr.
Paediatric Drugs
|March 3, 2026
Summary
Extended postnatal prophylaxis (ePNP) can help eliminate pediatric HIV. Single-drug regimens like lamivudine are effective and safer than multi-drug options for HIV-exposed infants.
Area of Science:
- Pediatric infectious diseases
- HIV/AIDS research
- Pharmacology and drug safety
Background:
- Preventing mother-to-child transmission (PMTCT) of HIV has advanced, but pediatric HIV elimination remains a challenge.
- Extended postnatal prophylaxis (ePNP) is a strategy involving antiretroviral prophylaxis for HIV-exposed infants after the initial PMTCT period.
- Current international recommendations need urgent updates to include ePNP.
Purpose of the Study:
- To evaluate the efficacy, safety, pharmacology, genetic barrier to resistance, and practicality of various extended postnatal prophylaxis (ePNP) regimens.
- To identify optimal ePNP strategies for preventing pediatric HIV transmission.
- To inform international guidelines for PMTCT.
Main Methods:
- Review and analysis of studies on antiretroviral drugs used in ePNP, including lamivudine, nevirapine, lopinavir/ritonavir, and zidovudine.
- Comparison of single-drug versus multi-drug ePNP regimens based on protective efficacy, toxicity, and other criteria.
- Consideration of factors like maternal HIV viral load to guide ePNP indication.
Main Results:
- Multi-drug ePNP regimens showed no superior protective efficacy compared to single-drug regimens.
- Combined antiretroviral drug regimens were associated with increased toxicity.
- Lamivudine and nevirapine emerged as preferred single-drug options for ePNP.
Conclusions:
- Single-drug ePNP regimens, particularly lamivudine or nevirapine, are recommended for their favorable benefit/risk profile.
- ePNP guided by maternal HIV viral load can optimize prophylaxis for high-risk infants.
- Future research should explore long-acting antiretrovirals and broadly neutralizing antibodies for pediatric HIV prevention.
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