The primary objective of this signal strengthening activity was to estimate the frequency of substitution of NVP with a protease inhibitor (PI) during the period 2008 to 2011 and to determine if any increase detected was statistically significant.
The incidence of NVP-related reactions of grade 3 and 4 increased with the implementation of Namibia’s 2010 ART Guidelines. The NVP safety signal of increased reports of grade 3 and 4 reactions was indeed a true signal. It is possible that initiating NVP-containing ART in women with high baseline CD4 counts, that is >250 cells/mm3, was the cause for the increase in the incidence of NVP-related grade 3 and 4 reactions. Therefore, the national HIV programme needs to review the use of NVP.