Nevirapine plasma concentration is associated with virologic failure and the emergence of drug-resistant mutations among HIV patients in Kenya: A cross sectional study.
Medicine (Baltimore)
; 101(50): e32346, 2022 Dec 16.
Article
in En
| MEDLINE
| ID: mdl-36550885
ABSTRACT
This study aimed to determine the association between the plasma concentration of nevirapine (NVP) and clinical outcomes. In this cross-sectional study, sociodemographic and clinical data were collected from 233 HIV patients receiving NVP-based first-line antiretroviral therapy (ART) regimens in Nairobi, Kenya. The mean age was 41.2 (SDâ
±â
11.9) years. Fifty-four (23.2%) patients had virological failure (>1000 copies/mL), whereas 23 (9.9%) were infected with drug-resistant HIV strains. Eleven patients had nucleoside reverse transcriptase inhibitor resistance mutations, including M184V and T215Y, whereas 22 had non-nucleoside reverse transcriptase inhibitor resistance mutations, including G190A, K103N, V106A, Y181C, A98G, and Y188L. The median NVP plasma concentration was 6180 ng/mL (IQR 4444-8843 ng/mL), with 38 (16.3%) patients having suboptimal NVP plasma levels of <3400 ng/mL. The majority 23 of the 38 (60.5%) patients with NVP Cminâ
<â
3400 ng/mL were significantly infected with drug-resistant HIV virus (Pâ
=â
.001). In the multivariate analysis, the time taken to arrive at the ART clinic (ß -11.1, 95% CI -21.2 to -1.1; Pâ
=â
.031), higher HIV viral load (ß -2008, 95% CI -3370.7 to -645.3; Pâ
=â
.004), and the presence of HIV drug resistance mutation (ß 3559, 95% CI 2580.8-4537.2; Pâ
=â
.0001) were associated with NVP plasma concentration. A significant proportion of patients receiving the NVP-based regimen had supra- and sub-therapeutic plasma concentrations. Higher HIV viral load and the presence of HIV drug-resistant mutations are important factors associated with NVP plasma concentrations.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
HIV-1
/
Anti-HIV Agents
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
Medicine (Baltimore)
Year:
2022
Document type:
Article
Affiliation country: