Severe CNS side-effect and persistent high efavirenz plasma levels in a patient with HIV/HCV coinfection and liver cirrhosis.
We describe an HIV/HCV coinfected patient with liver cirrhosis, who experienced severe CNS side-effects during efavirenz-based HIV therapy. Plasma levels of efavirenz were 10 times the upper limit and remained elevated (at twice the upper limit) 4 weeks after cessation of therapy. Efavirenz resistance (K103N) developed and was probably due to 'functional' monotherapy.
Bickel
Markus
M
HIV Treatment and Research Unit, JW Goethe University, Frankfurt, Germany. markusbickel@hotmail.com
Stephan
Christoph
C
Rottmann
Carsten
C
Carlebach
Amina
A
Haberl
Anette
A
Kurowski
Michael
M
Staszewski
Schlomo
S
D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000097:blood* / Q000627:therapeutic use; D048588:Benzoxazines; D003521:Cyclopropanes; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1 / Q000235:genetics; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000821:virology; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced*; D009154:Mutation; D010078:Oxazines / Q000009:adverse effects* / Q000097:blood* / Q000627:therapeutic use
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D010078:Oxazines; C098320:efavirenz