Zeruesenay Desta1, Roseann S Gammal2,3, Li Gong4, Michelle Whirl-Carrillo4, Aditya H Gaur5, Chonlaphat Sukasem6,7, Jennifer Hockings8, Alan Myers9, Marelize Swart1, Rachel F Tyndale10, Collen Masimirembwa11, Otito F Iwuchukwu12, Sanika Chirwa13, Jeffrey Lennox14, Andrea Gaedigk15, Teri E Klein4, David W Haas13,16. 1. Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA. 2. Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences University School of Pharmacy, Boston, Massachusetts, USA. 3. Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. 4. Department of Biomedical Data Science, Stanford University, Stanford, California, USA. 5. Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. 6. Division of Pharmacogenomics and Personalized Medicine, Faculty of Medicine Ramathibodi Hospital, Department of Pathology, Mahidol University, Bangkok, Thailand. 7. Laboratory for Pharmacogenomics, Faculty of Medicine Ramathibodi Hospital, Somdech Phra Debaratana Medical Center, Bangkok, Thailand. 8. Department of Pharmacy and Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA. 9. Department of Diagnostic & Biomedical Sciences, The University of Texas Health Sciences Center School of Dentistry, Houston, Texas, USA. 10. Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. 11. African Institute of Biomedical Science & Technology, Wilkins Hospital, Harare, Zimbabwe. 12. Division of Pharmaceutical Sciences, Fairleigh Dickinson University School of Pharmacy, Florham Park, New Jersey, USA. 13. Department of Internal Medicine, Meharry Medical College School of Medicine, Nashville, Tennessee, USA. 14. Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA. 15. Division of Clinical Pharmacology, Toxicology, & Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, Missouri, USA. 16. Departments of Medicine, Pharmacology, Pathology, Microbiology, & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Abstract
The HIV type-1 nonnucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV type-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.
The HIV type-1 nonnucleoside reverse transcriptase inhibitor, n class="Chemical">efavirenz, is widely used to treat HIV type-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.
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