Long-term benefits of nevirapine-containing regimens: multicenter study with 506 patients, followed-up a median of 9 years.
To evaluate long-term outcomes in patients maintaining a nevirapine (NVP)-based regimen.
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.
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.
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.
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
HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet de Llobregat, 08907 Barcelona, Spain. email@example.com
SourceCurrent HIV research 10:6 2012 Sep pg 513-20
MeSHAcquired Immunodeficiency Syndrome
CD4 Lymphocyte Count
Drug Therapy, Combination
Pub Type(s)Journal Article