title: Absence seizures associated with efavirenz initiation.
abstract: Efavirenz, used in treating pediatric human immunodeficiency virus infection, has central nervous system side effects. We report on a 5-year-old girl with perinatally acquired human immunodeficiency virus infection, presenting with new onset absence seizures after starting treatment with efavirenz. Plasma efavirenz values were above therapeutic range. The child was homozygous for the CYP2B6-516T/T genotype, which is associated with poor efavirenz clearance. Seizures abated after efavirenz discontinuation.
authors.affiliation: Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa. renate.strehlau@wits.ac.za
authors.forename: Renate
authors.initials: R
authors.lastname: Strehlau
authors.forename: Leigh
authors.initials: L
authors.lastname: Martens
authors.forename: Ashraf
authors.initials: A
authors.lastname: Coovadia
authors.forename: Collet
authors.initials: C
authors.lastname: Dandara
authors.forename: Jennifer
authors.initials: J
authors.lastname: Norman
authors.forename: Julia
authors.initials: J
authors.lastname: Maisel
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Abrams
mesh_terms: D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000097:blood; D001189:Aryl Hydrocarbon Hydroxylases / Q000172:deficiency / Q000235:genetics*; D048588:Benzoxazines / Q000009:adverse effects* / Q000097:blood; D002675:Child, Preschool; D003521:Cyclopropanes; D065702:Cytochrome P-450 CYP2B6; D004832:Epilepsy, Absence / Q000097:blood / Q000139:chemically induced / Q000235:genetics* / Q000503:physiopathology / Q000821:virology; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006678:HIV / Q000187:drug effects / Q000502:physiology*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000503:physiopathology / Q000821:virology; D006720:Homozygote; D006801:Humans; D010089:Oxidoreductases, N-Demethylating / Q000172:deficiency / Q000235:genetics*; D011110:Polymorphism, Genetic; D013019:South Africa; D019562:Viral Load / Q000187:drug effects
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D001189:Aryl Hydrocarbon Hydroxylases; C585599:CYP2B6 protein, human; D065702:Cytochrome P-450 CYP2B6; D010089:Oxidoreductases, N-Demethylating; C098320:efavirenz