Nevirapine-based regimens in routine clinical settings: results from a large Italian cohort of HIV-1 infected adults

Curr Drug Saf. 2011 Jul;6(3):138-44. doi: 10.2174/157488611797579339.

Abstract

We assessed the safety and efficacy of different nevirapine-based regimens in patients starting this drug in a large cohort of Caucasian subjects during the 1999-2007 periods.

Methods: A retrospective database review of all patients receiving nevirapine was performed; clinical, biochemical (hepatic and metabolic profiles), immuno-virological parameters were evaluated in the overall population and in different subgroups (according to gender, therapy-experience and HBV/HCV co-infection). We determined risk factors related to dyslipidemia development and to nevirapine interruption within 1 year.

Results: We evaluated 277 patients; 58 (20.9%) were naïve, 180 (65%) females and 137 (49.5%) HBV/HCV co-infected. After 48 weeks, 73.6% patients continued antiretroviral regimens. Among these, nevirapine showed little hepatic and metabolic impact, as well as good immuno-virological outcome despite sex, drug experience and co-infection. Factors related to development of dyslipidemia were higher in total cholesterol, female gender with high CD4 count and male gender with low CD4 count (p<0.05). Factors related to discontinue nevirapine were age and HBV/HCV co-infection (p<0.05).

Conclusions: We observed a high rate of discontinuation probably because of the special composition of our population (huge proportion of women and co-infected individuals). Nevertheless, nevirapine was a well-tolerated drug with a favorable impact on hepatic, metabolic and immuno-virological parameters in all the analyzed subgroups.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Cholesterol / blood
  • Cohort Studies
  • Databases, Factual
  • Dyslipidemias / etiology*
  • Female
  • HIV Infections / drug therapy*
  • Hepatitis B / complications
  • Hepatitis C / complications
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Nevirapine / administration & dosage
  • Nevirapine / adverse effects
  • Nevirapine / therapeutic use*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-HIV Agents
  • Cholesterol
  • Nevirapine