Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy

Clin Pharmacol Ther. 2019 Oct;106(4):726-733. doi: 10.1002/cpt.1477. Epub 2019 Jul 5.


The HIV type-1 nonnucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV type-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Alkynes
  • Anti-HIV Agents / pharmacology
  • Benzoxazines / pharmacology*
  • Cyclopropanes
  • Cytochrome P-450 CYP2B6 / genetics*
  • HIV Infections* / drug therapy
  • HIV Infections* / genetics
  • HIV-1*
  • Humans
  • Pharmacogenetics
  • Pharmacogenomic Testing / methods*
  • Practice Guidelines as Topic


  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cyclopropanes
  • CYP2B6 protein, human
  • Cytochrome P-450 CYP2B6
  • efavirenz