Oral adverse effects due to the use of Nevirapine.
OBJECTIVE
The aim of this article is to present the clinical characteristics and management of an oral adverse effect stemming from the use of the antiretroviral medication Nevirapine (NVP).


BACKGROUND
NVP is a non-nucleoside reverse transcriptase inhibitor used in the treatment of Human Immunodeficiency Virus (HIV) infection.


METHODS
A 29-year-old black man, HIV-infected since 1996, began highly active antiretroviral therapy (HAART) with zidovudine, lamivudine, and indinavir. From 1996 to 2002 several medications were changed due to their adverse effects: indinavir (renal colic and fever), nelfinavir (cutaneous rash), and efavirenz (nausea and temporary memory loss). When the patient presented to our service he was taking NVP, zidovudine, and lamivudine. A whitish plaque in the lips and bilateral buccal mucosa, burning, taste disturbance, and xerostomia were observed. The discontinuation of HAART led to the complete resolution of signs and symptoms. The patient has received follow-up treatment for three years and five months without local or systemic effects observed.


CONCLUSIONS
Unfortunately, the clinical features of the oral adverse effect from NVP are not well known. This paper contributed to the identification of possible reactions in the oral cavity due to antiretroviral medication. Although HAART is very important in the treatment of HIV, its side effects are responsible for patients' non-adherence to medications. While more studies are needed to better understand the mechanism of action after suspending HAART, the complete resolution of the signs and symptoms was observed. Therefore, physicians and dentists alike must understand how to identify and prevent these adverse effects in order to further improve HIV patient treatments.
Moura
Mariela Dutra Gontijo
MD
Department of Oral Surgery, Oral Medicine, and Oral Pathology of School of Dentistry at Universidade Federal de Minas Gerais and Orestes Diniz's Treatment Center of Parasitic and Infectious Diseases in Belo Horizonte, Brazil. dra.mariela@hotmail.com
Senna
Maria Inês Barreiros
MI
Madureira
Davidson Fróis
DF
Fonseca
Linaena Merícy Silva
LM
Mesquita
Ricardo Alves
RA
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002054:Burning Mouth Syndrome / Q000139:chemically induced; D018791:CD4 Lymphocyte Count; D005076:Exanthema / Q000097:blood / Q000139:chemically induced*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000097:blood / Q000139:chemically induced*; D019829:Nevirapine / Q000009:adverse effects*; D013651:Taste Disorders / Q000139:chemically induced; D019562:Viral Load; D014987:Xerostomia / Q000139:chemically induced
D019380:Anti-HIV Agents; D019829:Nevirapine