Journal
INFECTION GENETICS AND EVOLUTION
Volume 37, Issue -, Pages 192-207Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.meegid.2015.11.014
Keywords
Drug-drug interactions; Efavirenz; HIV; Nevirapine; Pharmacogenetics; Resource-limited countries
Categories
Funding
- University of Pennsylvania Center For AIDS Research International Core - NIH [P30 AI45008]
- Swedish Research Council [VR 2012-3440, VR-Link 2013-6710]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [P30AI045008] Funding Source: NIH RePORTER
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The burden of human immunodeficiency virus (HIV) is mainly concentrated to resources-limited countries where the response to available antiretroviral therapy is often limited by the occurrence of toxicity or by the emergence of HIV drug resistance. Efavirenz and nevirapine are the antiretroviral drugs most prescribed in resources-limited countries as part of antiretroviral combination therapy. Their metabolism and conjugation are largely influenced by enzymatic genetic polymorphisms. The genetic variability of their metabolism could be associated to different metabolic phenotypes causing reduced patients' adherence because of toxicity or drug-drug interactions with concomitant therapies. The purpose of this review is to summarize published evidence on pharmacogenetic and pharmacokinetic aspects related to efavirenz and nevirapine, the influence of concomitant anti-tubercular, anti-malarial or contraceptive treatments, and the impact of human genetic variation and drug-drug interaction on the virologic and immunologic response to antiretroviral therapy in resources-limited countries. (C) 2015 Elsevier B.V. All rights reserved.
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