Nevirapine-Induced Hepatotoxicity and Pharmacogenetics: A Retrospective Study in a Population from Mozambique

Abstract

Our preliminary results confirm the contribution of the ABCB1 c.3435C>T SNP in nevirapine-induced hepatotoxicity risk and, at the same time, suggest the necessity for further studies.

Pharmacogenetics of CYP2B6, CYP2A6 and UGT2B7 in HIV treatment in African populations: focus on efavirenz and nevirapine

“…In another HIV-positive South African population, the allele frequency of the 516G4T SNP was 43%, with 23% being homozygous and 41% heterozygous (Gounden et al, 2010). In a population from Mozambique, the 516G4T SNP was found in 41-49% of individuals, with 17-23% of individuals being homozygous (Ciccacci et al, 2010). The 785A4G SNP was found in 43-45% of these individuals, with 20% having a homozygous genotype.…”

“…Brown et al (2012) reported the 516G4T SNP to be significantly correlated with increased nevirapine exposure in a Malawian population. However, no significant association was found between the 516G4T SNP and nevirapine-induced hepatotoxicity in a Mozambiquan population (Ciccacci et al, 2010). More studies involving nevirapine plasma concentrations and CYP2B6 polymorphisms are thus needed to clarify these differences in observations.…”

“…In South Africa, nevirapine is also the preferred treatment for infants of HIV infected women to prevent mother to child transmission (Department of Health (DOH) Repulic of South Africa, 2013). Nevirapine is also still extensively used in other African regions due to its efficacy and affordability (Ciccacci et al, 2010). Decreased metabolism of nevirapine results in increased plasma levels leading to adverse side effects including hepatotoxicity (Haas et al, 2006).…”

“…Sarfo et al (2014) also reported a frequency of 4% in another Ghanaian population. The 983T4C SNP was reported in 9% of an HIV-positive Zimbabwean population (Maimbo et al, 2012), and in 5-7% of individuals in Mozambique, with no individuals being of a homozygous genotype (Ciccacci et al, 2010).…”

The Pharmacogenetics of HIV Treatment: A Practical Clinical Approach

“…The polymorphism ABCB1-3435C>T has been associated with a decreased risk of hepatotoxicty in patients receiving NVP [37][38][39]; nevertheless, this observation is paradoxical since a lower expression of P-gp would lead to a greater accumulation of NVP inside the hepatocytes.…”