Publication: Incidence and risk factors of rash associated with efavirenz in HIV-infected patients with preceding nevirapine-associated rash
Issued Date
2006-09-01
Resource Type
ISSN
14681293
14642662
14642662
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2-s2.0-33746450002
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Mahidol University
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SCOPUS
Bibliographic Citation
HIV Medicine. Vol.7, No.6 (2006), 378-382
Suggested Citation
Weerawat Manosuthi, S. Thongyen, N. Chumpathat, K. Muangchana, S. Sungkanuparph Incidence and risk factors of rash associated with efavirenz in HIV-infected patients with preceding nevirapine-associated rash. HIV Medicine. Vol.7, No.6 (2006), 378-382. doi:10.1111/j.1468-1293.2006.00396.x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/23310
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Title
Incidence and risk factors of rash associated with efavirenz in HIV-infected patients with preceding nevirapine-associated rash
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Abstract
Objective: To determine the incidence and risk factors of rash associated with efavirenz in HIV-infected patients with preceding nevirapine-associated rash. Methods: A retrospective cohort study was conducted in HIV-infected patients diagnosed with nevirapine-associated rash who subsequently received efavirenz between July 2003 and January 2005. Patients were followed up for 3 months after receiving efavirenz. Possible risk factors, including demographics, previous opportunistic infections, CD4 cell count, viral load, severity of nevirapine-associated rash and concurrent drugs, were studied and compared between those who had (group A) and did not have (group B) rash associated with efavirenz. Results: A total of 122 patients (52.5% male) were included in the study, with a mean age of 38.2 years. Median (and interquartile range) CD4 cell count and viral load were 55 (20-167) cells/μL and 86 150 (35 321-700 750) HIV-1 RNA copies/mL, respectively. Of the 122 patients, 10 (8.2%) developed rash associated with efavirenz and all required discontinuation of efavirenz. The baseline characteristics of group A (10 patients) and group B (112 patients) were similar. Median (and interquartile range) time from nevirapine discontinuation to efavirenz initiation was 12 (9-21) days in group A and 11 (7-21) days in group B (P = 0.765). None of the risk factors investigated was associated with developing rash associated with efavirenz. The preceding development of severe nevirapine-associated rash had a trend towards a higher rate in group A than in group B (20.0% vs 10.7%; odds ratio = 2.08; 95% confidence interval 0.39-10.97; P = 0.322). Conclusions: The majority (>90%) of HIV-infected patients with CD4 counts <200 cells/μL who had preceding nevirapine-associated rash could tolerate efavirenz well. Efavirenz may be an option for subsequent use in these patients, particularly in those who had preceding nevirapine-associated rash. © 2006 British HIV Association.