PMID- 18554312
OWN - NLM
STAT- MEDLINE
DCOM- 20090731
LR  - 20201209
IS  - 1468-1293 (Electronic)
IS  - 1464-2662 (Linking)
VI  - 9
IP  - 7
DP  - 2008 Aug
TI  - Efavirenz replacement by immediate full-dose nevirapine is safe in HIV-1-infected 
      patients in Cambodia.
PG  - 514-8
LID - 10.1111/j.1468-1293.2008.00597.x [doi]
AB  - BACKGROUND: Efavirenz is used for the antiretroviral treatment of 
      HIV/tuberculosis-coinfected patients in developing countries. A switch to 
      nevirapine is regularly carried out because of the cost and side effects of 
      efavirenz. Pharmacokinetic studies suggested that nevirapine should be initiated 
      at full dose when used as a substitute for efavirenz. OBJECTIVES: The aim of this 
      study was to measure the cumulative incidence of adverse events (AEs) related to 
      nevirapine in patients switched from efavirenz to immediate full-dose nevirapine 
      (FDN). METHODS: In 2001 an antiretroviral treatment programme was initiated with 
      the first-line regimen stavudine, lamivudine and efavirenz. In 2003, the 
      fixed-dose combination of stavudine, lamivudine and nevirapine was recommended. 
      Thus, first-line therapy was changed and FDN was initiated when patients were 
      switched from efavirenz to nevirapine. RESULTS: Between April and December 2004, 
      394 patients were switched from efavirenz to FDN. The cumulative incidence of AEs 
      related to nevirapine was 13.2% [95% confidence interval (CI) 10.2-16.7] and that 
      of severe AEs was 8.9% (95% CI 6.5-11.9). In women the incidence of AEs was 17.6% 
      (95% CI 12.1-24.3) and that of severe AEs was 12.2% (95% CI 7.7-18.2). 
      CONCLUSIONS: Our results indicate that an FDN switch from efavirenz does not 
      appear to result in more AEs than when nevirapine is initiated with escalating 
      doses. These data are particularly relevant in resource-limited settings.
FAU - Laureillard, D
AU  - Laureillard D
AD  - APHP, Department of Immunology, Georges Pompidou European Hospital, Paris, 
      France. didier.laureillard@egp.aphp.fr
FAU - Prak, N
AU  - Prak N
FAU - Fernandez, M
AU  - Fernandez M
FAU - Ngeth, C
AU  - Ngeth C
FAU - Moeung, S
AU  - Moeung S
FAU - Riel, V
AU  - Riel V
FAU - Chhneang, V
AU  - Chhneang V
FAU - Song, S
AU  - Song S
FAU - Quillet, C
AU  - Quillet C
FAU - Piketty, C
AU  - Piketty C
LA  - eng
PT  - Journal Article
DEP - 20080628
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
RN  - 0 (Alkynes)
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Benzoxazines)
RN  - 0 (Cyclopropanes)
RN  - 99DK7FVK1H (Nevirapine)
RN  - JE6H2O27P8 (efavirenz)
SB  - IM
MH  - Adult
MH  - Alkynes
MH  - Anti-HIV Agents/*adverse effects/therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - Benzoxazines/therapeutic use
MH  - Cambodia/epidemiology
MH  - Cyclopropanes
MH  - Exanthema/chemically induced/epidemiology
MH  - Female
MH  - HIV Infections/*drug therapy/virology
MH  - HIV-1
MH  - Hepatitis/epidemiology/etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nevirapine/*adverse effects/therapeutic use
MH  - Retrospective Studies
MH  - Stevens-Johnson Syndrome/chemically induced/epidemiology/etiology
MH  - Young Adult
EDAT- 2008/06/17 09:00
MHDA- 2009/08/01 09:00
CRDT- 2008/06/17 09:00
PHST- 2008/06/17 09:00 [pubmed]
PHST- 2009/08/01 09:00 [medline]
PHST- 2008/06/17 09:00 [entrez]
AID - HIV597 [pii]
AID - 10.1111/j.1468-1293.2008.00597.x [doi]
PST - ppublish
SO  - HIV Med. 2008 Aug;9(7):514-8. doi: 10.1111/j.1468-1293.2008.00597.x. Epub 2008 
      Jun 28.