The relationship between nevirapine plasma concentrations and the durability of both viral suppression (VS) and selection of nevirapine primary resistance mutations (PRMs) was evaluated. A nevirapine trough concentration (C trough ) of >4,300 ng/ml was found to predict longer VS. Patients with nevirapine C trough s ranging from 3,100 to 4,300 ng/ml had higher probabilities of developing PRMs than those with nevirapine C trough s below and above this concentration interval.In antiretroviral (ARV)-naive patients, nevirapine (NVP) plasma exposure was shown to affect the time to reach virological suppression (VS) and overall response at 52 weeks (5). However, no data have yet been obtained about the effects of NVP plasma concentrations on the long-term durability of VS in a heterogeneous clinical setting. Moreover, failure of NVPcontaining regimens is known to be frequently, but not invariably, associated with the appearance of NVP-associated primary resistance mutations (NVP-PRMs) (2). Nevertheless, the influence of NVP plasma exposure on the selection of NVPPRMs is unknown. Therefore, our aims were to evaluate the relationship between NVP trough concentrations (C trough ) and the durability of VS and to assess the effect of NVP C trough on the selection of NVP-PRMs.Nonnucleoside reverse transcriptase inhibitor (non-NRTI)-naive patients who initiated, between 2000 and mid-2003, a regimen containing NVP (200 mg, twice a day) plus two NRTIs were retrospectively selected from our cohort in January 2004. These patients included ARV-naive subjects, ARV-experienced subjects with virological failure (VF), and patients switching from protease inhibitor-based regimens with viral loads (VLs) of Ͻ50 copies/ml. Regular follow-up (every 3 months), achievement of VS, availability of at least one detectable NVP concentration, and self-reported compliance (no more than two drug intakes missed in the last week at the time of pharmacokinetic sampling) were the main inclusion criteria.

Skin disorders are an important problem in children living in developing countries, but only a few epidemiologic investigations on pediatric dermatoses are available in the literature. Our study is an analysis of the range and frequency of skin diseases presenting to the Italian Dermatological Center in a pediatric Ethiopian population. A retrospective analysis was performed on 17,967 medical records of children aged 0 to 18 years attending the Italian Dermatological Centre in Mekele (Ethiopia) from January 2005 to December 2009. Infections and infestations accounted for 47% of the disorders seen; fungal infections were the most common (44.1%), followed by bacterial and parasitic diseases. Dermatitis constituted the second most common diagnostic category (24.7%) of the disorders seen, and contact dermatitis was the most common diagnosis (48.8%). Pigmentary disorders and disorders of skin appendages were more common in girls, whereas fungal and parasitic infections were more common in boys. Bacterial and parasitic infections were more common in children younger than 1 year old, fungal infections in those aged 1 to 5.9, and disorders of skin appendages and pigmentary disorders in those aged 15 to 18. These findings demonstrate that most of the disorders seen could be easily managed in clinical practice with appropriate skill development. It is crucial to ensure that training of medical students and pediatricians focuses on accurate recognition, diagnosis, and management of these common skin diseases and that families, teachers, health workers, and nurses be educated about the most common signs of prevalent skin diseases to help facilitate appropriate care.

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