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Clinical Safety and Long-Term Efficacy of Nevirapine Among Women in an Urban HIV Clinic: A Case Series

Bhatti, Laveeza MD, PhD

Infectious Diseases in Clinical Practice: July 2011 - Volume 19 - Issue 4 - pp 268-272
doi: 10.1097/IPC.0b013e31820dc5f5
Original Articles

Background: Women with human immunodeficiency virus (HIV) are now living longer, and few publications have addressed the long-term clinical safety and efficacy of nevirapine in this group.

Methods: The charts from 20 women were chosen from among 50 women currently receiving nevirapine and were reviewed for the patients' medical history, HIV RNA levels, CD4+ cell counts, and laboratory parameters.

Results: The 20 women had been patients at an urban HIV clinic for a mean time of 6.7 years (range, 3-10 years), were on average 46 years old (range, 34-61 years), and had been living with an HIV/acquired immunodeficiency syndrome diagnosis for about 15 years (range, 6-22 years). Most women had multiple co-morbidities, including depression, cardiovascular disease, psychiatric disorders, hepatitis C, and some had abnormal Papanicolaou test results. The women received nevirapine (twice a day, n = 12; once a day,a n = 8) for about 5 years (range, 2-10 years). Of the women who switched to nevirapine (n = 6), the reasons were varied but included better gastrointestinal tolerability, safer choice for pregnancy, simplicity, and hyperlipidemia. All women fared well on their antiretroviral therapy with good efficacy of their regimen as evidenced by a mean CD4+ count of 495 cells/mm3 (range, 118-1262 cells/mm3) and HIV RNA levels of less than 48 copies/mL. No marked changes in body weight, lipid parameters, and liver function values were noted during nevirapine treatment. Moreover, tolerability was excellent as indicated by the fact that none of the women complained of any adverse drug reactions.

Conclusions: Data from this case series support the long-term use of nevirapine in HIV-infected women.

From the AIDS Healthcare Foundation, Los Angeles, CA.

Correspondence to: Laveeza Bhatti, MD, PhD, AIDS Healthcare Foundation, 7732 Stewart Ave, Los Angeles, CA 90045-1054. E-mail: lbhatti@yahoo.com.

This work was supported by Boehringer-Ingelheim Pharmaceuticals, Inc (BIPI). Editorial assistance was provided by Linda Merkel, PhD, Envision Scientific Solutions, Inc, which was contracted by BIPI for these services. Dr Bhatti has been a study investigator and consultant for BIPI and has served on advisory boards and the Speakers Bureau for BIPI.

The author meets criteria for authorship as recommended by the International Committee of Medical Journal Editors, was fully responsible for all content and editorial decisions, and was involved at all stages of manuscript development. The author received no compensation related to the development of the manuscript.

aOnce daily use of viramune is not an Food and Drug Administration-approved dosing regimen.

© 2011 Lippincott Williams & Wilkins, Inc.