Switching to Nevirapine (Viramune) Appears Generally Safe for Patients with High
CD4 Cell Counts Treatment guidelines re However, recent studies indicate that switching to nevirapine may be safe
for patients who previously had a CD4 cell count below these levels, but experienced
good immune recovery after starting antiretroviral therapy. Such a switch may
be undertaken since nevirapine is less likely to cause blood fat elevations In an analysis of the ATHENA cohort, for example, investigators found that
patients on HAART with an undetectable viral load who switched to nevirapine after
their CD4 cell count rose above these thresholds were no more likely to experience
serious reactions than treatment-naive people with lower CD4 counts. However,
patients switching with a detectable viral load did have a higher risk.* At
the recent 47th
Interscience Conference on Antimicrobial Agents and Chemotherapy in The
investigators identified 6 trials -- which included a total of 550 patients --
that Results ·
Using an
intent-to-treat analysis, replacement of protease inhibitors with nevirapine was
shown to be “non-inferior” to continuing on protease inhibitor-based therapy in
terms of maintaining viral load suppression (81% vs 78%). ·
Rates of
discontinuation due to adverse events were similar in the switch and unchanged
therapy groups (6.81% vs 9.00%). ·
At end of
follow-up, there were no differences between the 2 groups with regard to CD4 cell
counts, cholesterol or triglyceride levels, or body shape measurements. ·
2 of the
studies reported greater improvements in quality of life in the nevirapine group
Conclusion Based
on these findings, the researchers concluded that, “Protease inhibitors replacement
with nevirapine is virologically effective and safe in patients with high CD4
lymphocyte cell counts and those with hepatitis C virus infection.” 09/28/07 References
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