title: Efavirenz intoxication due to a new CYP2B6 constellation.
abstract: Here, we describe severe neuropsychiatric symptoms in an HIV-positive Asian man with extremely high efavirenz plasma levels while receiving standard treatment with efavirenz/tenofovir/emtricitabine fixed-dose regimen. Genetic examination revealed compound homozygosity for loss-of-function alleles of CYP2B6, including coding for a rare truncated protein. Neuropsychiatric symptoms resolved completely after efavirenz discontinuation.
authors: Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
authors: Alexia
authors: A
authors: Anagnostopoulos
authors: Margalida
authors: M
authors: Rotger
authors: Manel
authors: M
authors: Aouri
authors: Stefan P
authors: SP
authors: Kuster
authors: Amalio
authors: A
authors: Telenti
authors: Laurent A
authors: LA
authors: Décosterd
authors: Huldrych F
authors: HF
authors: Günthard
mesh_terms: D000328:Adult; D000480:Alkynes; D000483:Alleles; D019380:Anti-HIV Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics / Q000378:metabolism*; D048588:Benzoxazines / Q000378:metabolism*; D003521:Cyclopropanes; D065702:Cytochrome P-450 CYP2B6; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000201:enzymology / Q000235:genetics; D015497:HIV-1; D006801:Humans; D008297:Male; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide; D018894:Reverse Transcriptase Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D001189:Aryl Hydrocarbon Hydroxylases; C585599:CYP2B6 protein, human; D065702:Cytochrome P-450 CYP2B6; C098320:efavirenz