Abstract

OBJECTIVE
To evaluate long-term outcomes in patients maintaining a nevirapine (NVP)-based regimen.
METHODS
Retrospective, multicenter, cohort study including patients currently receiving an NVP regimen that had been started at least 5 years previously. Demographic, clinical, and analytical variables were recorded.
RESULTS
Median follow-up was 8.9 (5.7-11.3) years. Baseline characteristics: 74% men, 47 years old, 36% drug users, 40% AIDS, 40% HCV+, 51.4% detectable HIV-1 viral load, CD4 count 395 (4-1,421)/μL, 19% CD4 < 200/μL, 27% ALT grade 1-2, 36% AST grade 1-2. Thirty percent ART-naive, 83%received NVP associated with 2 nucleoside analogues during the study period, and 17% a protease inhibitor. A significant improvement was observed in general health status markers, including hemoglobin, platelets, and albumin, regardless of HCV coinfection. CD4 cell gain was +218 and +322/μL after 6 and 9 years, respectively (+321 and +391 in naive patients). Triglycerides significantly decreased in pretreated patients, whereas the percentage of patients with HDLc < 1.03 mmol/L and LDL-c > 3.37 mmol/L significantly decreased in a subsample with available values. A significant decrease in transaminases, alkaline phosphatase, and Fib4 score was observed, mainly in HCV+ and ARV-naive patients.
CONCLUSIONS
In patients who tolerate NVP therapy, (even those with HCV coinfection), long term benefits may be significant in terms of a progressive improvement in general health status markers and CD4 response, a favorable lipid profile, and good liver tolerability.

Links

Publisher Full Text

Authors

Podzamczer D, Tiraboschi JM, Mallolas J, Curto J, Cárdenes MA, Casas E, Castro A, Echevarría S, Leal M, Lopez Bernaldo de Quirós JC, Moreno S, Puig T, Ribera E, Villalonga C, Gómez-Sirvent JL, García-Henarejos JA, Lopez-Aldeguer J, Barrufet P, Force L, Santos I, Sanz J

Institution

HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet de Llobregat, 08907 Barcelona, Spain. dpodzamczer@bellvitgehospital.cat

Source

Current HIV research 10:6 2012 Sep pg 513-20

MeSH

Acquired Immunodeficiency Syndrome
Anti-HIV Agents
CD4 Lymphocyte Count
Cholesterol
Cohort Studies
Coinfection
Drug Therapy, Combination
Female
Follow-Up Studies
Hepatitis C
Humans
Liver
Male
Middle Aged
Nevirapine
Retrospective Studies
Spain
Substance-Related Disorders
Time Factors
Treatment Outcome
Triglycerides
Viral Load

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22716109