Long-term benefits of nevirapine-containing regimens: multicenter study with 506 patients, followed-up a median of 9 years.
OBJECTIVE
To evaluate long-term outcomes in patients maintaining a nevirapine (NVP)-based regimen.


METHODS
Retrospective, multicenter, cohort study including patients currently receiving an NVP regimen that had been started at least 5 years previously. Demographic, clinical, and analytical variables were recorded.


RESULTS
Median follow-up was 8.9 (5.7-11.3) years. Baseline characteristics: 74% men, 47 years old, 36% drug users, 40% AIDS, 40% HCV+, 51.4% detectable HIV-1 viral load, CD4 count 395 (4-1,421)/μL, 19% CD4 < 200/μL, 27% ALT grade 1-2, 36% AST grade 1-2. Thirty percent ART-naive, 83%received NVP associated with 2 nucleoside analogues during the study period, and 17% a protease inhibitor. A significant improvement was observed in general health status markers, including hemoglobin, platelets, and albumin, regardless of HCV coinfection. CD4 cell gain was +218 and +322/μL after 6 and 9 years, respectively (+321 and +391 in naive patients). Triglycerides significantly decreased in pretreated patients, whereas the percentage of patients with HDLc < 1.03 mmol/L and LDL-c > 3.37 mmol/L significantly decreased in a subsample with available values. A significant decrease in transaminases, alkaline phosphatase, and Fib4 score was observed, mainly in HCV+ and ARV-naive patients.


CONCLUSIONS
In patients who tolerate NVP therapy, (even those with HCV coinfection), long term benefits may be significant in terms of a progressive improvement in general health status markers and CD4 response, a favorable lipid profile, and good liver tolerability.
HIV Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet de Llobregat, 08907 Barcelona, Spain. dpodzamczer@bellvitgehospital.cat
D
D
Podzamczer
J M
JM
Tiraboschi
J
J
Mallolas
J
J
Curto
M A
MA
Cárdenes
E
E
Casas
A
A
Castro
S
S
Echevarría
M
M
Leal
J C
JC
Lopez Bernaldo de Quirós
S
S
Moreno
T
T
Puig
E
E
Ribera
C
C
Villalonga
J L
JL
Gómez-Sirvent
J A
JA
García-Henarejos
J
J
Lopez-Aldeguer
P
P
Barrufet
L
L
Force
I
I
Santos
J
J
Sanz
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D060085:Coinfection; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D014280:Triglycerides; D002784:Cholesterol; D019829:Nevirapine