Publication: Risk factors for nevirapine-associated rash among HIV-infected patients with low CD4 cells counts in resource-limited settings
Issued Date
2008-01-01
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ISSN
1570162X
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2-s2.0-40449096002
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Mahidol University
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SCOPUS
Bibliographic Citation
Current HIV Research. Vol.6, No.1 (2008), 65-69
Suggested Citation
Sasisopin Kiertiburanakul, Somnuek Sungkanuparph, Angkana Charoenyingwattana, Surakameth Mahasirimongkol, Thanyachai Sura, Wasun Chantratita Risk factors for nevirapine-associated rash among HIV-infected patients with low CD4 cells counts in resource-limited settings. Current HIV Research. Vol.6, No.1 (2008), 65-69. doi:10.2174/157016208783571946 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/19385
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Title
Risk factors for nevirapine-associated rash among HIV-infected patients with low CD4 cells counts in resource-limited settings
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Abstract
Nevirapine (NVP) is commonly used as a component of first-line antiretroviral therapy in resource-limited countries. We aimed to determine the risk factors for NVP-associated rash among HIV-infected patients who were initiated NVP at low CD4 cell counts in a resource-limited setting. A case-control study was conducted in HIV-infected patients who developed rash after taking NVP (case) and those who did not have rash (control). A total of 357 patients with a mean (SD) age of 36.4 (7.5) years and 52.1% male were included in the study. Mean body weight (SD) was 55.5 (10.5) kg. Of all, 179 (49.0%) patients had a history of AIDS-defining illness and 57 (16.0%) patients had history of drug allergy. Median (IQR) CD4 cell counts at the time of NVP initiation was 95 (31-226) cells/mm3. There were 115 patients in case group and 242 patients in control group. In case group, 43.0%, 54.4%, and 2.6% of patients developed grade 2, 3, and 4 of rash, respectively. Median time to develop rash was 12 (95%CI, 10.5-13.5) days. By logistic regression, history of drug allergy (OR, 3.41; 95%CI, 1.79-6.52), body weight (OR, 1.22 per each 5 kg decrement; 95%CI, 1.08-1.38), CD4 cells counts (OR, 1.20 per each 50 cells/mm3increment; 95%CI, 1.12-1.30), and AIDS-defining illness (OR, 0.42; 95%CI, 0.25-0.70) were significantly associated with rash. In resource-limited settings where patients were initiated NVP at low CD4 cell counts, history of drug allergy, lower body weight, and higher CD4 cell count are the risk factors for NVP-associated rash. Initiation of NVP in patients with these risks needs closed monitoring. © 2008 Bentham Science Publishers Ltd.