Nevirapine-Based Regimens in Routine Clinical Settings: Results from a Large Italian Cohort of HIV-1 Infected Adults

Raffaella      Rosso; Roberto      Rossotti; Antonio      Di Biagio; Laura      Nicolini; Fulvio      Adorni; Anna      Orani; Claudio      Viscoli

doi:10.2174/157488611797579339

Abstract

We assessed the safety and efficacy of different nevirapine-based regimens in patients starting this drug in a large cohort of Caucasian subjects during the 1999-2007 periods. Methods. A retrospective database review of all patients receiving nevirapine was performed; clinical, biochemical (hepatic and metabolic profiles), immuno-virological parameters were evaluated in the overall population and in different subgroups (according to gender, therapy-experience and HBV/HCV co-infection). We determined risk factors related to dyslipidemia development and to nevirapine interruption within 1 year. Results. We evaluated 277 patients; 58 (20.9%) were naïve, 180 (65%) females and 137 (49.5%) HBV/HCV co-infected. After 48 weeks, 73.6% patients continued antiretroviral regimens. Among these, nevirapine showed little hepatic and metabolic impact, as well as good immuno-virological outcome despite sex, drug experience and co-infection. Factors related to development of dyslipidemia were higher in total cholesterol, female gender with high CD4 count and male gender with low CD4 count (p < 0.05). Factors related to discontinue nevirapine were age and HBV/HCV co-infection (p < 0.05). Conclusions. We observed a high rate of discontinuation probably because of the special composition of our population (huge proportion of women and co-infected individuals). Nevertheless, nevirapine was a well-tolerated drug with a favorable impact on hepatic, metabolic and immuno-virological parameters in all the analyzed subgroups.

Keywords: HIV-1, nevirapine, dyslipidemia, co-infection, HBV, HCV, metabolic and immuno-virological parameters, Risk factor for HIV infection, CD4+ Lymphocyte cell count, HIV-RNA