In recent times there has been a growing research interest in Nevirapine an antiretroviral medication that prevents human immunodeficiency virus cells from multiplying in the blood. Nevirapine comes as tablet and a suspension (liquid) often taken by mouth, it is taken with or without once a day for 2 weeks and twice a day after the first 2 weeks. It is best to swallow nevirapine with liquids such as water, milk or soda. Feeding experiments in various animal species and humans have highlighted the beneficial role of nevirapine on health. These benefits include significant reduction in acquired immune deficiency syndrome-related morbidity and mortality. However, nevirapine hypersensitivity reaction can lead to morbidity through treatment interruption, inconvenience and loss of productivity. Additionally, nevirapine has an excellent bioavailability and a long half-life. This increases the risk of non-nucleoside reverse transcriptase inhibitor resistance when patients discontinue all the other antiretroviral drugs in the regimen at the same time. Thus, this can lead to decreased therapeutic options if nevirapine resistance develops. The gastrointestinal tract is a major portal of entry of nutrients into the body and nevirapine first make contact with the gastrointestinal tract. The health of an individual is dependent on the nutrient absorbed and hence functional integrity of the gastrointestinal tract. Studies have revealed that the interaction with drug have led to disruption of gastrointestinal function.

Background: Nevirapine is an antiretroviral medication that prevents human immunodeficiency virus cells from multiplying in the blood. This study was undertaken to ascertain whether nevirapine administration affects bile secretion in albino Wistar rats. Methods: Male and female albino Wistar rats (n=20, 50-125 g body weight) at the start of the experiment were used for the study. Rats in the control group (n=10) were administered normal saline (0.4 mg/kg body weight) + normal rodent chow, whereas the nevirapine group (n=10) were fed by gavage nevirapine (0.4 mg/kg body weight) two times daily (07:00 h and 18:00 h) in addition to normal rodent chow for 12 weeks. All animals were allowed free access to clean drinking water. Biliary secretion, cholesterol, bilirubin, conjugated and unconjugated bilirubin levels, and bile electrolytes were measured. Results: Biliary secretion in the nevirapine-treated group was significantly lower (p<0.05) than in the control group. Total cholesterol, total bilirubin and unconjugated bilirubin were significantly higher (p<0.001) in the nevirapinetreated group when compared to control. Conjugated bilirubin was also increased in the nevirapine-treated group though not statistically different from the control. Electrolytes (sodium and chlorine) content of bile were significantly lower (p<0.01 and p<0.001) in the nevirapine-treated group when compared to control. However, (potassium and bicarbonate) content of bile were significantly higher (p<0.05 and p<0.001) in the nevirapine-treated group when compared to control. Conclusion: Long term administration of nevirapine may lead to reduction in biliary secretion, increase bilirubin/ cholesterol levels and alter bile electrolytes' composition. This implies that NVP may provoke liver damage.

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Long term administration of nevirapine causes functional derangement of various tissues. This study was therefore carried out to determine the effect of long term administration of nevirapine on intestinal fluid and glucose absorption in albino Wistar rats using the everted sac technique. Twenty albino Wistar rats (both sexes) were divided into two groups of ten rats per group. The first group served as the control and was fed with normal rat chow while the second group was fed nevirapine (0.4 mg/kg body weight) by gavage once daily for 2 weeks after which the dosage was doubled by administering the drug twice daily for 12 weeks. Villus height and crypt depth were measured. The gut fluid uptake (jejunum/ileum) in nevirapine-treated rats were significantly lower (p<0.001) when compared to control; gut glucose uptake (jejunum/ileum) were significantly lower (p<0.001and p<0.05) in the nevirapine-treated group of rats when compared to control. The villus height (duodenum, jejunum, ileum) in the nevirapine-treated group was significantly lower (p<0.01, p<0.01, p<0.001) as compared to control group. The crypt depth (duodenum, jejunum, ileum) in the nevirapine-treated group was significantly lower (p<0.001, p<0.01, p<0.01) when compared to control. These results suggest that long term administration of nevirapine may lead to distortion in villus morphology with a concomitant mal-absorption of fluid and glucose in rats.