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Nevirapine Plasma Concentrations Are Still Detectable after More
Than 2 Weeks in the Majority of Women Receiving Single-Dose Nevirapine
Single-dose
nevirapine is a highly cost-effective strategy
to reduce perinatal
HIV-1 transmission. Its major disadvantage is the
selection of nevirapine resistance in 20% to 30% of women, probably
attributable to the long elimination half-life of nevirapine.
In
order to develop intervention strategies, it is important to know
the interpatient variability in nevirapine half-life in women receiving
a single dose of nevirapine
HIV-negative, healthy, non-pregnant
Dutch women were eligible for this study. After administration of
a single 200-mg dose of nevirapine to the subjects, blood was sampled
for measurement of nevirapine twice a week for a total of 21 days.
Nevirapine plasma levels were determined
by a validated high-performance liquid chromatography method with
a lower limit of quantification of 0.15 mg/L. The primary end point
was the first sample with an undetectable nevirapine concentration.
Results
· Forty-four
subjects participated.
· The
median age, height, and body weight (interquartile range) were 26
(21-33) years, 1.72 (1.68-1.75) m, and 64 (59-75) kg, respectively.
· The
median elimination half-life of nevirapine was 56.7 hours, with
a range of 25.6 to 164 hours.
· The time to the first
undetectable nevirapine plasma concentration was 10 days in 4 subjects,
14 days in 12 subjects, 17 days in 12 subjects, and 21 days in 9
subjects.
· In the remaining 7
subjects, nevirapine was still detectable on day 21, the last day
of sampling.
· Time to an undetectable
nevirapine plasma concentration was influenced by oral contraceptive
use but not by age, height, body weight, body surface area, alcohol
use, or smoking.
The authors conclude, “Most women who
received a single 200-mg nevirapine dose still had detectable plasma
concentrations of nevirapine after more than 2 weeks.”
Further, the authors note, “This information
is valuable for designing intervention studies to prevent the development
of nevirapine resistance.”
07/13/05
Reference
E
Muro and others. Nevirapine Plasma Concentrations are Still Detectable
After More Than 2 Weeks in the Majority of Women Receiving Single-Dose
Nevirapine: Implications for Intervention Studies.
Journal of Acquired Immune Deficiency Syndromes 39(4): 419-421,
August 1, 2005.
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