Nevirapine susceptibility factors

Observational studies In 2190 adults taking stavudine and nevirapine (median followup 1.5 years), stavudine had to be replaced in 175 (8.0%) because of neuropathy, in 69 (3.1%) because of lactic acidosis and in 157 (7.2%) because of Upoatrophy significant susceptibility factors associated with lactic acidosis and late neuropathy included a higher baseline body weight and older age advanced HIV disease increased the risk of neuropathy [661. 

In 330 HIV-positive, of whom 267 received nevirapine-based antiretroviral therapy and 63 received efavirdine-based therapy there was a significant difference in the rates of hepatotoxicity 133 (50%) of the patients on nevirapine had at least one episode of a rise on alanine aminotransferase activity over a median follow-up period of 21 months, or 285 cases per 1000 person-years [96 ]. A baseline rise in activity (OR = 14) and hepatitis C co-infection (OR=3) were susceptibility factors, and a high CD4-I- cell count was protective. 

Liver In 296 patients, of whom 151 took efavirenz and 145 nevirapine, there was severe hepatotoxicity (grade 3 to 4 rises in aspartate and/or alanine aminotransferases) in two of the former and three of the latter, and mild-to-moderate hepatotoxicity (grade 2 rises) in 6.0% and 3.4% [137 ]. The only susceptibility factor for mild-to-moderate hepatotoxicity was hepatitis C co-infection. 

Susceptibility factors Genetic In HIV-infected Thai patients HLA-B 3505 had a 99% specificity in identifying nevirapine-induced rashes [166 ]. 

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