Influence of liver fibrosis stage on plasma levels of efavirenz in HIV-infected patients with chronic hepatitis B or C

Meynard, Jean-Luc; Lacombe, Karine; Poirier, Jean‐Marie; Legrand, J; Morand‐Joubert, Laurence; Girard, Pierre‐Marie

doi:10.1093/jac/dkn531

Cited by 23 publications

(15 citation statements)

References 12 publications

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“…13.0%, respectively). In studies from largely Caucasian populations, high efavirenz concentrations (> 4.0 mg/L) have been reported in 13.1–18.9% of participants . By contrast, a study of 80 South African patients, with a median efavirenz concentration of 3.98 mg/L, found that the proportion of patients with high efavirenz concentrations was 40% .…”

Section: Discussionmentioning

confidence: 94%

Prospective plasma efavirenz concentration assessment in Chinese HIV‐infected adults enrolled in a large multicentre study

et al. 2018

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Section: Discussionmentioning

confidence: 94%

Prospective plasma efavirenz concentration assessment in Chinese HIV‐infected adults enrolled in a large multicentre study

et al. 2018

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“…6,7,15,16 Other groups have found an association with female sex and antiretroviral-naïve patients undergoing their first regimen, 11 or if their regimen contains a protease inhibitor. 17 Lamivudine and ritonavir have also been implicated.…”

Section: Discussionmentioning

confidence: 99%

“…22 Furthermore, up to 20% of patients exhibit plasma levels of efavirenz that exceed the therapeutic range. 15 …”

Section: Discussionmentioning

confidence: 99%

EFV/FTC/TDF-Associated Hepatotoxicity: A Case Report and Review

Echenique

Rich

2013

AIDS Patient Care and STDs

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The fixed-dose combination efavirenz, emtricitabine, and tenofovir (EFV/FTC/TDF) is a first-line agent for the treatment of HIV. We report the case of a 40-year-old female with a history of HIV acquired through heterosexual contact who initiated EFV/FTC/TDF. Hepatitis B and C serologies were negative, CD4 cell count was 253 cells per cubic millimeter (15.8%), and HIV viral load was 67,373 copies per milliliter. Eight months later she developed transaminitis and severe right upper quadrant pain. Neither illicit drug abuse nor hepatotoxic medication such as acetaminophen was reported. After evaluation including negative acute viral hepatitis studies, EFV/FTC/TDF was discontinued; both her transaminitis and pain resolved. Hepatotoxicity is most often associated with efavirenz. Rarely, fulminant hepatic failure occurs. Efavirenz-related hepatotoxicity is thought to result from a cellular self-digestion process known as autophagy. This is the first report to our knowledge of EFV/FTC/TDF-related hepatotoxicity.

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“…However, administration of these medications in this setting is challenging because of the alteration of hepatic metabolism and the risk of drug-induced liver injury [170]. Of note, hepatic metabolism of NNRTIs, particularly efavirenz, is impaired in coinfected patients with cirrhosis, and a similar effect has also been observed for protease inhibitors [171].…”

Section: Management Of Hiv Patients Coinfected With Hcv And/or Hbv Inmentioning

confidence: 99%

Management of HIV and hepatitis virus coinfection

Mendes-Corrêa

Núñez²

2010

Expert Opinion on Pharmacotherapy

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Anti-HBV treatment in the HIV-coinfected patient relies on the available NRTIs with activity against both viruses. Whereas HBV suppression can be achieved with this approach, toxicities and the selection of HBV-resistant variants result in challenging clinical scenarios. Current anti-HCV treatment (pegylated interferon and ribavirin) has limited efficacy in the HIV-coinfected patient, and STAT-C drugs are eagerly awaited.

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Influence of liver fibrosis stage on plasma levels of efavirenz in HIV-infected patients with chronic hepatitis B or C

Abstract: Therapeutic drug monitoring may be of interest in cirrhotic patients more at risk of side effects due to efavirenz overdosing.

Cited by 23 publications

References 12 publications

Prospective plasma efavirenz concentration assessment in Chinese HIV‐infected adults enrolled in a large multicentre study

Prospective plasma efavirenz concentration assessment in Chinese HIV‐infected adults enrolled in a large multicentre study

EFV/FTC/TDF-Associated Hepatotoxicity: A Case Report and Review

Management of HIV and hepatitis virus coinfection

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