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Standard‐dose efavirenz vs. standard‐dose nevirapine in antiretroviral regimens among HIV‐1 and tuberculosis co‐infected patients who received rifampicin
Author(s) -
Manosuthi W,
Mankatitham W,
Lueangniyomkul A,
Chimsuntorn S,
Sungkanuparph S
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00563.x
Subject(s) - efavirenz , medicine , nevirapine , interquartile range , rifampicin , tuberculosis , adverse effect , odds ratio , confidence interval , gastroenterology , viral load , human immunodeficiency virus (hiv) , immunology , antiretroviral therapy , pathology
Background There is limited comparative data between efavirenz (EFV) 600 mg/day and nevirapine (NVP) 400 mg/day‐based antiretroviral therapy (ART) among HIV‐1 patients with tuberculosis (TB) and receiving rifampicin. Methods A retrospective cohort study was conducted in all ART‐naïve patients who were receiving rifampicin between January 2002 and December 2005. Results Of 188 patients, 77 and 111 patients were initiated on EFV‐based ART (EFV group) and NVP‐based ART (NVP group), respectively. Overall, median [interquartile range (IQR)] CD4 count was 36 (15–77) cells/μL and median (IQR) viral load was 5.6 (5.2–5.9) HIV‐1 RNA log copies/mL. At 48 weeks, 77.9% (60/77) in the EFV group and 67.6% (75/111) in the NVP group achieved HIV‐1 RNA <50 copies/mL ( P =0.140, odds ratio =0.590, 95% confidence interval=0.302–1.153). At 24 and 48 weeks, respective median CD4 counts were 174 and 254 cells/μL in the EFV group and 156 and 218 cells/μL in the NVP group ( P >0.05). By binary logistic regression, treatment group was not associated with HIV‐1 RNA <50 copies/mL ( P >0.05). No patient in the EFV group and eight (7.2%) patients in the NVP group discontinued ART because of adverse reactions ( P =0.084). Conclusions For HIV–TB co‐infected patients who receive rifampicin, efficacy of 600 mg EFV‐based and 400 mg NVP‐based ART may be similar, although adverse events tend to be higher in NVP‐based ART.