Plasma nevirapine levels, adverse events and efficacy of antiretroviral therapy among HIV-infected patients concurrently receiving nevirapine-based antiretroviral therapy and fluconazole

• Main Authors: Phoorisri Thanongsri, Uttayamakul Sumonmal, Athichathanabadi Chatiya, Manosuthi Weerawat, Sungkanuparph Somnuek
• Format: Article
• Language: English
• Published: BMC 2007-03-01
• Series: BMC Infectious Diseases
• Online Access: http://www.biomedcentral.com/1471-2334/7/14

<p>Abstract</p> <p>Background</p> <p>The clinical data of plasma NVP level, safety and efficacy of antiretroviral therapy (ART) for the concurrent use of nevirapine (NVP)-based ART and fluconazole (FLU) is scanty.</p> <p>Methods</p> <p>A retrospective study was conducted in patients who were initiated NVP-based ART between October 2004 and November 2005. The objectives were to compare NVP levels, adverse events, and 36-week efficacy of NVP-based ART between patients who did not receive FLU (group A) and those who received FLU 200 mg/day or 400 mg/day (group B).</p> <p>Results</p> <p>There were 122 patients with mean ± SD age of 36 ± 9 years; 81 in group A and 41 in group B. Median (IQR) baseline CD4 cell count was 29 (8–79) cell/mm³in group A and 19 (8–33) cell/mm³in group B (<it>P </it>= 0.102). Baseline characteristics between the two groups were similar. Mean ± SD NVP levels were 6.5 ± 3.0 mg/L in group A and 11.4 ± 6.1 mg/L in group B(<it>P </it>< 0.001). One (2.4%) patient in group B developed clinical hepatitis (<it>P </it>= 0.336). Six (7.4%) patients in group A developed NVP-related skin rashes (<it>P </it>= 0.096). There were no differences in term of 36-week antiviral efficacy between the two groups (<it>P </it>> 0.05).</p> <p>Conclusion</p> <p>Co-administration of NVP and daily dosage of FLU (200 mg/day and 400 mg/day) results in markedly increased trough plasma NVP level when compared to the administration of NVP alone. The concurrent use of NVP and FLU in very advanced HIV-infected patients is well-tolerated. The immunological and virological responses are favorable.</p>