title: Nevirapine-related adverse events among children switched from efavirenz to nevirapine as compared to children who were started on nevirapine-based antiretroviral therapy directly.
abstract: In this retrospective study, incidence of nevirapine (NVP) toxicity in children who were switched from efavirenz (EFV) to NVP (treatment experienced [TE] group) was compared with that of children who had started NVP-based antiretroviral therapy directly (treatment naïve [TN] group). This study also identified risk factors associated with development of NVP toxicity in children. The incidence and risk of developing NVP toxicities were significantly higher in TE when compared to TN group. Median duration of onset of NVP toxicity from the initiation was 2.14 and 3.84 weeks in TE and TN children, respectively. Mean CD4 count was found to be significantly higher in children who developed toxicity (577 ± 81 cells/µL) as compared to the children who did not develop toxicity (403 ± 29 cells/µL). Similarly, children in TE group who developed NVP toxicity had higher mean CD4 cell count than children in TN with NVP toxicity. The risk factors for the development of NVP toxicity include female gender with CD4 count >250 cells/μL and TE children especially girls with CD4% >15% and boys with CD4 count >400 cells/μL. To conclude, the higher incidence of NVP toxicity among TE group warrants a cautious approach while switching the NVP- from EFV-based therapy.
authors.affiliation: a Department of Pediatrics , Indira Gandhi Institute of Child Health , Bangalore , India.
authors.forename: G N
authors.initials: GN
authors.lastname: Sanjeeva
authors.forename: V
authors.initials: V
authors.lastname: Sukanya
authors.forename: H B
authors.initials: HB
authors.lastname: Pavithra
authors.forename: S K
authors.initials: SK
authors.lastname: Dodderi
authors.forename: B B
authors.initials: BB
authors.lastname: Rewari
authors.forename: M
authors.initials: M
authors.lastname: Govindaraj
authors.forename: S
authors.initials: S
authors.lastname: Shivananda
authors.forename: R
authors.initials: R
authors.lastname: Premalatha
mesh_terms: D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D048588:Benzoxazines / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D004342:Drug Hypersensitivity / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz
keywords: NVP toxicities; switching; treatment experienced; treatment naive