OBJECTIVE: To measure nevirapine elimination in African adults undertaking a structured treatment interruption (STI) in the DART trial. DESIGN: Cohort (16 women, 5 men; median weight 61 kg) within a randomized trial of management strategies. METHODS: Plasma nevirapine was measured by validated high performance liquid chromatography at 0,1,2,3 and 4 weeks after stopping the drug in a subset of patients undertaking an STI. All patients continued lamivudine plus zidovudine/stavudine for a further 7 days. RESULTS: Two patients with no or low plasma nevirapine concentration at baseline were excluded. Geometric mean plasma concentration when nevirapine was stopped in the remaining 19 patients was 6421 ng/ml (range, 3724-9473). Nevirapine was detected in 15/18 (83%) patients at 1 week, and 5/19 (26%) patients at 2 weeks but was not found any samples collected after 2 weeks. Only one patient had > 100 ng/ml (limit of quantification) at 2 weeks (415 ng/ml, female). The median times to reach thresholds of 200, 100 and 20 ng/ml (limit of detection) were estimated to be 7.6 [interquartile range (IQR), 7.0-10.1], 9.3 (IQR, 8.7-13.0) and 13.2 (IQR, 12.3-18.4) days, respectively, with 3/19 (16%) and 14/19 (74%) estimated to have reached < 20 ng/ml by 7 and 14 days, respectively. CONCLUSION: Although elimination of nevirapine was faster than previously published after a single dose, the data suggest that an additional staggered period of 7-10 days with dual nucleotide reverse transcriptase inhibitor cover is necessary for African patients discontinuing nevirapine.
OBJECTIVE: To measure nevirapine elimination in African adults undertaking a structured treatment interruption (STI) in the DART trial. DESIGN: Cohort (16 women, 5 men; median weight 61 kg) within a randomized trial of management strategies. METHODS: Plasma nevirapine was measured by validated high performance liquid chromatography at 0,1,2,3 and 4 weeks after stopping the drug in a subset of patients undertaking an STI. All patients continued lamivudine plus zidovudine/stavudine for a further 7 days. RESULTS: Two patients with no or low plasma nevirapine concentration at baseline were excluded. Geometric mean plasma concentration when nevirapine was stopped in the remaining 19 patients was 6421 ng/ml (range, 3724-9473). Nevirapine was detected in 15/18 (83%) patients at 1 week, and 5/19 (26%) patients at 2 weeks but was not found any samples collected after 2 weeks. Only one patient had > 100 ng/ml (limit of quantification) at 2 weeks (415 ng/ml, female). The median times to reach thresholds of 200, 100 and 20 ng/ml (limit of detection) were estimated to be 7.6 [interquartile range (IQR), 7.0-10.1], 9.3 (IQR, 8.7-13.0) and 13.2 (IQR, 12.3-18.4) days, respectively, with 3/19 (16%) and 14/19 (74%) estimated to have reached < 20 ng/ml by 7 and 14 days, respectively. CONCLUSION: Although elimination of nevirapine was faster than previously published after a single dose, the data suggest that an additional staggered period of 7-10 days with dual nucleotide reverse transcriptase inhibitor cover is necessary for African patients discontinuing nevirapine.
Authors: Dongning Wang; Charles B Hicks; Neela D Goswami; Emi Tafoya; Ruy M Ribeiro; Fangping Cai; Alan S Perelson; Feng Gao Journal: J Virol Date: 2011-04-13 Impact factor: 5.103
Authors: Cynthia Firnhaber; Livio Azzoni; Andrea S Foulkes; Robert Gross; Xiangfan Yin; Desiree Van Amsterdam; Doreen Schulze; Deborah K Glencross; Wendy Stevens; Gillian Hunt; Lynn Morris; Lawrence Fox; Ian Sanne; Luis J Montaner Journal: PLoS One Date: 2011-06-28 Impact factor: 3.240
Authors: Dineke Frentz; David A M C Van de Vijver; Ana B Abecasis; Jan Albert; Osamah Hamouda; Louise B Jørgensen; Claudia Kücherer; Daniel Struck; Jean-Claude Schmit; Jurgen Vercauteren; Birgitta Åsjö; Claudia Balotta; Danail Beshkov; Ricardo J Camacho; Bonaventura Clotet; Suzie Coughlan; Algirdas Griskevicius; Zehava Grossman; Andrzej Horban; Tatjana Kolupajeva; Klaus Korn; Leondios G Kostrikis; Kirsi Liitsola; Marek Linka; Claus Nielsen; Dan Otelea; Dimitrios Paraskevis; Roger Paredes; Mario Poljak; Elisabeth Puchhammer-Stöckl; Anders Sönnerborg; Danica Stanekova; Maja Stanojevic; Eric Van Wijngaerden; Annemarie M J Wensing; Charles A B Boucher Journal: BMC Infect Dis Date: 2014-07-21 Impact factor: 3.090
Authors: Tim R Cressey; Hannah Green; Saye Khoo; Jean-Marc Treluyer; Alexandra Compagnucci; Yacine Saidi; Marc Lallemant; Diana M Gibb; David M Burger Journal: Clin Infect Dis Date: 2008-05-15 Impact factor: 9.079
Authors: Sarah Fidler; Kholoud Porter; Fiona Ewings; John Frater; Gita Ramjee; David Cooper; Helen Rees; Martin Fisher; Mauro Schechter; Pontiano Kaleebu; Giuseppe Tambussi; Sabine Kinloch; Jose M Miro; Anthony Kelleher; Myra McClure; Steve Kaye; Michelle Gabriel; Rodney Phillips; Jonathan Weber; Abdel Babiker Journal: N Engl J Med Date: 2013-01-17 Impact factor: 91.245