Pharmacogenetics of Efavirenz: Adherence and Virologic Outcomes
Authors: Jean B. Nachega, Gary Maartens
Journal: Annals of Internal Medicine (2007)

Letters4 December 2007Pharmacogenetics of Efavirenz: Adherence and Virologic OutcomesJean B. Nachega, MD, MPH and Gary Maartens, MBChBJean B. Nachega, MD, MPHFrom Johns Hopkins University, Baltimore, MD 21205, and University of Cape Town, 7925 Cape Town, South Africa.Search for more papers by this author and Gary Maartens, MBChBFrom Johns Hopkins University, Baltimore, MD 21205, and University of Cape Town, 7925 Cape Town, South Africa.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-11-200712040-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Cennimo for bringing up this interesting point. The primary aim of our analysis was to assess the relationship between adherence and virologic outcomes on NNRTI regimens, and we caution that our finding of superior outcomes for efavirenz compared with nevirapine must be regarded as preliminary.The homozygous CYP2B6 position 516 TT genotype was found in 3.4% of European Americans and 20% of African Americans in the AIDS Clinical Trials Group study A5097s (1), close to 50% in participants in a study from Ghana (2), and 13.1% of participants in a recent South African study (3). ...References1. Haas DW, Ribaudo HJ, Kim RB, Tierney C, Wilkinson GR, Gulick RM, et al. Pharmacogenetics of efavirenz and central nervous system side effects: an Adult AIDS Clinical Trials Group study. AIDS. 2004;18:2391-400. [PMID: 15622315] MedlineGoogle Scholar2. Klein K, Lang T, Saussele T, Barbosa-Sicard E, Schunck WH, Eichelbaum M, et al. Genetic variability of CYP2B6 in populations of African and Asian origin: allele frequencies, novel functional variants, and possible implications for anti-HIV therapy with efavirenz. Pharmacogenet Genomics. 2005;15:861-73. [PMID: 16272958] CrossrefMedlineGoogle Scholar3. Cohen K, Grant A, Dandara C, McIlleron H, Pemba L, Churchyard G, et al. The effect of rifampicin and cytochrome P450 2B6 genotype on efavirenz mid-dosing interval plasma concentrations in South African adults [Abstract]. Presented at the 8th International Workshop on Clinical Pharmacology of HIV Therapy, Budapest, Hungary, 16-18 April 2007. Google Scholar4. Ribaudo HJ, Haas DW, Tierney C, Kim RB, Wilkinson GR, Gulick RM, et al. Pharmacogenetics of plasma efavirenz exposure after treatment discontinuation: an Adult AIDS Clinical Trials Group Study. Clin Infect Dis. 2006;42:401-7. [PMID: 16392089] CrossrefMedlineGoogle Scholar5. Rates of disease progression according to initial highly active antiretroviral therapy regimen: a collaborative analysis of 12 prospective cohort studies. J Infect Dis. 2006;194:612-22. [PMID: 16897660] CrossrefMedlineGoogle Scholar6. Braithwaite RS, Kozal MJ, Chang CC, Roberts MS, Fultz SL, Goetz MB, et al. Adherence, virological and immunological outcomes for HIV-infected veterans starting combination antiretroviral therapies. AIDS. 2007;21:1579-89. [PMID: 17630553] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University, Baltimore, MD 21205, and University of Cape Town, 7925 Cape Town, South Africa.Disclosures:Honoraria: J.B. Nachega (GlaxoSmithKline, Merck-Sharp-Dohme for continuing medical education lectures), G. Maartens (Merck-Sharp-Dohme). Grants received: G. Maartens (Merck-Sharp-Dohme). Other: J.B. Nachega (Aspen Pharmaceuticals for conferences and travel grants). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAdherence to Nonnucleoside Reverse Transcriptase Inhibitor–Based HIV Therapy and Virologic Outcomes Jean B. Nachega , Michael Hislop , David W. Dowdy , Richard E. Chaisson , Leon Regensberg , and Gary Maartens Pharmacogenetics of Efavirenz: Adherence and Virologic Outcomes David J. Cennimo Metrics 4 December 2007Volume 147, Issue 11Page: 817-818KeywordsAntiretroviralsClinical trialsCohort studiesConflicts of interestDrugsMedical educationMutationPharmacogeneticsPopulation statistics ePublished: 4 December 2007 Issue Published: 4 December 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...