Prediction of plasma efavirenz concentrations among HIV-positive patients taking efavirenz-containing combination antiretroviral therapy.

ABSTRACT: We investigated the predictors of plasma mid-dose concentrations (C12) of efavirenz by enrolling 456 HIV-positive patients who had received 2 nucleos(t)ide reverse-transcriptase inhibitors plus efavirenz (600?mg daily) for 2 weeks or longer and had their CYP2B6 516G>T polymorphism and efavirenz C12 determined. The median efavirenz C12 was 2.41?mg/L (IQR, 1.93-3.14). In analysis of covariance models, patients with CYP2B6 516GT and TT genotypes compared to those with GG genotype had higher efavirenz C12 (for GT genotype, an increase by 0.976?mg/L [95%CI, 0.765-1.188], and TT genotype, 4.871?mg/L [95%CI, 4.126-5.616]), while per 10-kg increment in weight decreased C12 by 0.199?mg/L (95%CI, 0.111-0.287). Models incorporating CYP2B6 516G>T polymorphism and weight had moderate predictive values in predicting efavirenz C12???2?mg/L (ROC area under curve?=?0.706 [95%CI, 0.656-0.756]). In the absence of CYP2B6 516G>T polymorphism, weight??58?kg provided better predictabilities for efavirenz C12???2?mg/L (probability, 77.1% [95%CI, 69.0-83.5%] for weight?=?50?kg and 70.6% [95%CI, 64.1-76.4%] for weight?=?58?kg).

SUBMITTER: Huang SH 

PROVIDER: S-EPMC5701031 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature