Plasma Concentrations, Efficacy and Safety of Efavirenz in HIV-Infected Adults Treated for Tuberculosis in Cambodia

ALT Dieter Telemans

The objective of this study was to assess efavirenz plasma concentrations and their association with treatment efficacy and tolerance of efavirenz 600 mg daily in HIV-tuberculosis co-infected patients. HIV-infected adults with CD4+ T cell count ≤200/mm3 received standard 6-month tuberculosis treatment and antiretroviral therapy including a daily-dose of 600 mg of efavirenz, irrespective of their body weight. Mid-dose blood samples were drawn both on tuberculosis treatment (week +2 and week +6 after antiretroviral therapy initiation, and week 22 of follow-up) and off tuberculosis treatment (week 50 of follow-up). Considered therapeutic range was 1,000 to 4,000 ng/mL. Multivariate analysis was performed to evaluate the association between efavirenz concentration below 1,000 ng/mL and virological failure. Linear regression was used to test the association between efavirenz exposure and CD4+ T cell gain. Severe side effects potentially related to efavirenz were described and their association with efavirenz exposure was tested by multivariate analysis.

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Authors: Laurence Borand, Yoann Madec, Didier Laureillard, Monidarin Chou, Olivier Marcy, Phearavin Pheng, Narom Prak, Chindamony Kim, Khemarin Kim Lak, Chanroeun Hak, Bunnet Dim, Eric Nerrienet, Arnaud Fontanet, Thim Sok, Anne E. Goldfeld, François-Xavier Blanc, Anne-Marie Taburet

Journal: Public Library of Science (PLoS) One

Keyword(s): HIV / AIDS