Long-term benefits of nevirapine-containing regimens: multicenter study with 506 patients, followed-up a median of 9 years.

Abstract

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.

• Authors: D Podzamczer, J M Tiraboschi, J Mallolas, J Curto, M A Cárdenes, E Casas, A Castro, S Echevarría, M Leal, J C Lopez Bernaldo de Quirós, S Moreno, T Puig, E Ribera, C Villalonga, J L Gómez-Sirvent, J A García-Henarejos, J Lopez-Aldeguer, P Barrufet, L Force, I Santos, J Sanz
• Journal: Current HIV research (Curr HIV Res) Vol. 10 Issue 6 Pg. 513-20 (Sep 2012) ISSN: 1873-4251 [Electronic] Netherlands
• PMID: 22716109 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Anti-HIV Agents
• Triglycerides
• Cholesterol
• Nevirapine

Topics

• Acquired Immunodeficiency Syndrome (blood, drug therapy, epidemiology)
• Anti-HIV Agents (administration & dosage)
• CD4 Lymphocyte Count
• Cholesterol (blood)
• Cohort Studies
• Coinfection
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hepatitis C (blood, drug therapy, epidemiology)
• Humans
• Liver (drug effects)
• Male
• Middle Aged
• Nevirapine (administration & dosage)
• Retrospective Studies
• Spain (epidemiology)
• Substance-Related Disorders (epidemiology)
• Time Factors
• Treatment Outcome
• Triglycerides (blood)
• Viral Load