Powis, KathleenLockman, ShahinAjibola, GbolahanHughes, Michael D.Bennett, KaraLeidner, JeanBatlang, OganneBotebele, KerapetseMoyo, Sikhulilevan Widenfelt, ErikMakhema, JosephPetlo, ChipoJibril, Haruna B.McIntosh, KennethEssex, MaxShapiro, Roger2018-05-302018Powis, K. M., S. Lockman, G. Ajibola, M. D. Hughes, K. Bennett, J. Leidner, O. Batlang, et al. 2018. “Similar HIV protection from four weeks of zidovudine versus nevirapine prophylaxis among formula-fed infants in Botswana.” Southern African Journal of HIV Medicine 19 (1): 751. doi:10.4102/sajhivmed.v19i1.751. http://dx.doi.org/10.4102/sajhivmed.v19i1.751.http://nrs.harvard.edu/urn-3:HUL.InstRepos:37068098Background: The World Health Organization HIV guidelines recommend either infant zidovudine (ZDV) or nevirapine (NVP) prophylaxis for the prevention of intrapartum mother-to-child HIV transmission (MTCT) among formula-fed infants. No study has evaluated the comparative efficacy of infant prophylaxis with twice daily ZDV versus once daily NVP in exclusively formula-fed HIV-exposed infants. Methods: Using data from the Mpepu Study, a Botswana-based clinical trial investigating whether prophylactic co-trimoxazole could improve infant survival, retrospective analyses of MTCT events and Division of AIDS (DAIDS) Grade 3 or Grade 4 occurrences of anaemia or neutropenia were performed among infants born full-term (≥ 37 weeks gestation), with a birth weight ≥ 2500 g and who were formula-fed from birth. ZDV infant prophylaxis was used from Mpepu Study inception. A protocol modification mid-way through the study led to the subsequent use of NVP infant prophylaxis. Results: Among infants qualifying for this secondary retrospective analysis, a total of 695 (52%) infants received ZDV, while 646 (48%) received NVP from birth for at least 25 days but no more than 35 days. Confirmed intrapartum HIV infection occurred in two (0.29%) ZDV recipients and three (0.46%) NVP recipients (p = 0.68). Anaemia occurred in 19 (2.7%) ZDV versus 12 (1.9%) NVP (p = 0.36) recipients. Neutropenia occurred in 28 (4.0%) ZDV versus 21 (3.3%) NVP recipients (p = 0.47). Conclusions: Both ZDV and NVP resulted in low intrapartum transmission rates and no significant differences in severe infant haematologic toxicity (DAIDS Grade 3 or Grade 4) among formula-fed full-term infants with a birthweight ≥ 2500 g.en-USJournal Article2018-05-3010.4102/sajhivmed.v19i1.751