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9th Annual Conference Of The British HIV Association [BHIVA]24 – 26 April 2003, University of Manchester
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[AUTHOR(S):] SE Gibbons1, L Almond1, H Reynolds1, L Dickinson1, L Robinson1, SH Khoo1, M Boffito1,2, S Bonora2, G Di Perri2 and DJ Back1
1 Department of Pharmacology, University of Liverpool, UK, and 2 University of Torino, Italy
BHIVA Conf 2003 Apr 24-26;9:P3
BACKGROUND: Nevirapine (NVP) is extensively metabolised by the liver and there is concern about the development of hepatotoxicity in subjects receiving NVP. It has been suggested that high plasma NVP concentrations may predispose patients to the development of toxicity; recent data from the 2NN study comparing once and twice daily NVP possibly lends support to the role of drug concentrations in driving toxicity. In addition to dose regimen, factors such as body weight, sex and HCV co-infection need to be considered.
METHODS: (1) A retrospective analysis was performed on peak (1–4 h) and trough (10–14 hours post dose) samples received by the Liverpool Therapeutic Drug Monitoring (TDM) Service for NVP quantification from adults receiving NVP at 200 mg twice a day. The relationship between plasma NVP and sex, weight and body mass index was investigated. (2) NVP concentrations in a heterogenous cohort of HIV+ patients were related to markers of hepatotoxicity, hepatitis C (HCV) co-infection, sex and weight.
RESULTS: (1) TDM samples from females had a greater percentage of NVP trough concentrations 2× or 3× the target concentration of 3000 ng/ml (45% versus 25% and 21% versus 11%, females versus males). There was a correlation between peak NVP and weight (n=92; P=0.009). (2) Cohort patients showed a weak association between higher NVP concentrations and laboratory abnormalities. Subjects with γ-glutamyl transferase and/or alanine aminotransferase over the upper limit of normal had significantly higher NVP concentrations. HCV co-infection was significantly associated with higher NVP levels.
CONCLUSIONS: These data highlight some of the potential factors influencing NVP plasma concentrations.
PRESENTING AUTHOR: SE Gibbons
030424
P3
Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD