Tolerance of a Short Course of Nevirapine, Associated With 2 Nucleoside Analogues, in Postexposure Prophylaxis of HIV

Abstract

A combination of 2 nucleoside analogues and 1 protease inhibitor is usually recommended in postexposure prophylaxis. Because of the complex treatment schedule and frequent adverse effects, however, this regimen is often not completed. Therefore, since January 2000, we have used nevirapine (NVP), 200 mg/d, for only 4 days in combination with 2 nucleoside analogues for 1 month to improve adherence and completion rates. We present a 2-year retrospective analysis on 120 individuals who received this prophylaxis. Only 2 subjects stopped NVP because of a clinical event, whereas 10 interrupted the nucleoside analogues. We observed 3 (2.8%) of 104 slight alanine aminotransferase (ALT) increases in the first 2 weeks of treatment (grade 1). Three additional (month 1 or 3) ALT augmentations also occurred (also grade 1). No HIV or hepatitis C virus seroconversion occurred during follow-up. Twenty-nine (38.2%) of 76 individuals and 21 (47.7%) of 44 individuals were seen 3 months after nonoccupational and occupational exposure, respectively. We believe that such a short course (4 days) of 200-mg NVP treatment once a day in combination with 2 nucleoside analogues for 1 month is clinically and biologically safe.

Electrodeposition of Copper Oxide Nanoparticles on Precasted Carbon Nanoparticles Film for Electrochemical Investigation of anti‐HIV Drug Nevirapine

“…Nevirapine (NEV), (11‐cyclopropyl‐5,11‐dihydro‐4‐methyl‐6 H ‐dipyrido [3,2‐b:2′,3′‐e][1,4]diazepin‐6‐one) (Scheme ) is one of the members of the non‐nucleoside reverse transcriptase inhibitors that acts against human immunodeficiency virus type 1 (HIV‐1) 3–5. This compound interferes with viral RNA to DNA‐directed polymerase activities by binding directly and reversibly to the catalytic site of the reverse transcriptase enzyme 6. Due to rapid development of HIV resistance to NEV, therapy including combinations with other reverse transcriptase inhibitors such as stavudine and lamivudine is recommended 6–9.…”

“…This compound interferes with viral RNA to DNA‐directed polymerase activities by binding directly and reversibly to the catalytic site of the reverse transcriptase enzyme 6. Due to rapid development of HIV resistance to NEV, therapy including combinations with other reverse transcriptase inhibitors such as stavudine and lamivudine is recommended 6–9.…”

Electrochemical studies of nevirapine, an anti-HIV drug, and its assay in tablets and biological samples

“…NVP binds directly and reversibly to the catalytic site of the reverse transcriptase enzyme, and therefore interferes with viral RNA to DNA-directed polymerase activities [3]. It is recommended for treating HIV infections in combination with other reverse transcriptase inhibitors such as stavudine and lamivudine [4][5][6][7].…”

“…Presently, four classes of antiretroviral drugs are available viz., (i) nucleoside/tide reverse transcriptase (NRTI) inhibitors, (ii) non-nucleoside (NNRTI) inhibitors, (iii) protease (PI) inhibitors and (iv) fusion inhibitors [1]. Nevirapine (NVP), (11-cyclopropyl-4-methyl-5, 11-dihydro-6H-dipyrido [3,2-b:2′,3′-e] [1,4]diazepin-6-one) ( Figure 1) is a NNRTI with activity against human immunodeficiency virus type 1 (HIV-1) [2]. NVP binds directly and reversibly to the catalytic site of the reverse transcriptase enzyme, and therefore interferes with viral RNA to DNA-directed polymerase activities [3].…”

Spectrophotometric determination of nevirapine using tetrathiocyanatocobalt(II) ion as a reagent

“…It is an inducer of cytochrome P450 isoenzymes CYP3A4 and CYP2B6 [4,5]. Nevirapine in triple combination therapy has been shown to suppress viral load effectively when used as initial antiretroviral therapy [6,7]. It is a potent and selective non--competitive inhibitor of reverse transcriptase, an important therapeutic target for treatment of HIV-1.…”