Twelve-year experience of nevirapine use: benefits and convenience for long-term management in a French cohort of HIV-1-infected patients.
OBJECTIVE
To describe safety and long-term efficacy of nevirapine (NVP) in a real-life setting.


RESULTS
From 1996 to 2008, among the 745 patients who received NVP, 592 were still followed in our center; of these, 231 had stopped NVP because of failure (42%), side effects (28%), other causes (30%). Twenty-seven percent of discontinuations occurred in the first 3 months; 68% were related to adverse events. In June 2008, 361/592 patients (61%) were still on NVP for a median duration of 176 weeks (range, 0.3-600), including 18% of naïve patients, 15% of patients who initiated NVP in the context of virologic failure, and 66% of patients with an undetectable viral load (switch strategy). Median CD4 cell count increased from 377/microL (range, 8-1449) to 549/microL (range, 144-1621). Viral load was below 200 copies/mL at the latest visit in 97%, 96%, and 100% of the patients in the naïve, failure, and switch groups, respectively. Over a 5-year period, the rate of antiretroviral drug persistence was 60.9% for NVP, 41.4% for efavirenz, and 23% for lopinavir/ritonavir (P < .0001).


CONCLUSIONS
In a real-life setting, NVP demonstrates sustained efficacy and good safety and is very convenient to use as reflected by a high rate of persistency.
Reliquet
Véronique
V
Infectious Diseases Department, University Hospital, Nantes, France.
Allavena
C
C
Morineau-Le Houssine
P
P
Mounoury
O
O
Raffi
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine