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- Title
Plasma concentrations of efavirenz are associated with body weight in HIV-positive individuals.
- Authors
Poeta, Julia; Linden, Rafael; Antunes, Marina Venzon; Real, Lucia; Menezes, Andréia Magalhães; Ribeiro, Jorge P.; Sprinz, Eduardo
- Abstract
Background Efavirenz is among the most widely used antiretroviral drugs. Increased efavirenz exposure has been associated with CNS side effects and also with the chance of emergence of resistance upon treatment interruptions. The objective of this study was to evaluate factors associated with efavirenz plasma concentrations in a cohort of HIV-infected individuals. Methods From July 2009 to March 2010, HIV-infected patients with efavirenz as part of antiretroviral therapy (600 mg at night), undetectable viral load for at least 1 year and CD4 cell count >200 cells/mm3 were consecutively enrolled at the HIV/AIDS ambulatory care unit in southern Brazil. Plasma samples were taken 18–23 h after efavirenz last dose and analysed by validated ultra-performance liquid chromatography. Results Forty-one subjects were included (21 females). Mean age and weight were 45.4 years and 70.9 kg, respectively. Mean efavirenz plasma concentration was 2.20 ± 2.17 mg/L. Most plasma concentrations (73%) were within the therapeutic window (1–4 mg/L); 17% were below and 10% above the limits. There were no significant associations between efavirenz concentration and age, CD4 cell count, time on antiretroviral treatment and gender. There was significant and inverse correlation between efavirenz concentrations and body weight (P = 0.013) and body mass index (P = 0.001). Conclusions In this cohort of well-controlled HIV-positive individuals, patients with lower weight or body mass index had a higher chance of presenting elevated plasma concentrations of efavirenz. Therapeutic drug monitoring to adjust dose might be a helpful tool to decrease efavirenz dose in order to minimize costs and adverse effects.
- Subjects
EFAVIRENZ-emtricitabine-tenofovir (Drug); ANTIRETROVIRAL agents; HIV-positive persons; ANTIVIRAL agents; PHARMACODYNAMICS; CHROMATOGRAPHIC analysis; DRUG analysis
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2011, Vol 66, Issue 11, p2601
- ISSN
0305-7453
- Publication type
Article
- DOI
10.1093/jac/dkr360