title: Effect of CYP2B6, ABCB1, and CYP3A5 polymorphisms on efavirenz pharmacokinetics and treatment response: an AIDS Clinical Trials Group study.
abstract: In AIDS Clinical Trials Group protocols 384, A5095, and A5097s, we characterized relationships between 22 polymorphisms in CYP2B6, ABCB1, and CYP3A5; plasma efavirenz exposure; and/or treatment responses. A stepwise logistic regression procedure selected polymorphisms associated with reduced drug clearance adjusted for body mass index and the composite CYP2B6 516/983 genotype. Relationships between selected polymorphisms and treatment responses were characterized by competing risk methodology. Association analyses involved 821 individuals (317 for pharmacokinetics and 643 for treatment response). Models that included CYP2B6 516/983 genotype best predicted pharmacokinetics. Slow-metabolizer genotypes were associated with increased central nervous system events among white participants and decreased virologic failure among black participants.
authors.affiliation: Statistical Data Analysis Center, Harvard School of Public Health, Harvard University, Boston, MA, USA.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Ribaudo
authors.forename: Huan
authors.initials: H
authors.lastname: Liu
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwab
authors.forename: Elke
authors.initials: E
authors.lastname: Schaeffeler
authors.forename: Michel
authors.initials: M
authors.lastname: Eichelbaum
authors.forename: Alison A
authors.initials: AA
authors.lastname: Motsinger-Reif
authors.forename: Marylyn D
authors.initials: MD
authors.lastname: Ritchie
authors.forename: Ulrich M
authors.initials: UM
authors.lastname: Zanger
authors.forename: Edward P
authors.initials: EP
authors.lastname: Acosta
authors.forename: Gene D
authors.initials: GD
authors.lastname: Morse
authors.forename: Roy M
authors.initials: RM
authors.lastname: Gulick
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Robbins
authors.forename: David
authors.initials: D
authors.lastname: Clifford
authors.forename: David W
authors.initials: DW
authors.lastname: Haas
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics*; D000480:Alkynes; D019380:Anti-HIV Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D048588:Benzoxazines / Q000493:pharmacokinetics* / Q000627:therapeutic use; D044383:Black People; D003521:Cyclopropanes; D065702:Cytochrome P-450 CYP2B6; D051544:Cytochrome P-450 CYP3A / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000208:ethnology / Q000235:genetics; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D010089:Oxidoreductases, N-Demethylating / Q000235:genetics*; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide; D018894:Reverse Transcriptase Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016896:Treatment Outcome; D044465:White People
chemical_list: C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D001189:Aryl Hydrocarbon Hydroxylases; C585599:CYP2B6 protein, human; C510164:CYP3A5 protein, human; D065702:Cytochrome P-450 CYP2B6; D051544:Cytochrome P-450 CYP3A; D010089:Oxidoreductases, N-Demethylating; C098320:efavirenz