Virological, immunological, and clinical impact of switching from protease inhibitors to nevirapine or to efavirenz in patients with human immunodeficiency virus infection and long-lasting viral suppression

Eugenia Negredo, Luís Cruz, Roger Paredes, Lidia Ruiz, Carmina R. Fumaz, Anna Bonjoch, Silvia Gel, Albert Tuldrà, Montserrat Balagué, Susan Johnston, Albert Arnó, Antoni Jou, Cristina Tural, Guillem Sirera, Joan Romeu, Bonaventura Clotet

Research output: Contribution to journalArticlepeer-review

165 Scopus citations

Abstract

Seventy-seven subjects infected with human immunodeficiency virus were randomized to switch from protease inhibitor (PI) therapy to nevirapine therapy (group A; n = 26) or to efavirenz therapy (group B; n = 25) or to continue PI therapy (group C; n = 26). At month 12, viral suppression had been maintained in 96% of patients in group A, 92% of patients in group B, and 92% of patients in group C. A significant increase in the CD4+ level was observed in all 3 groups. In group A, lipid profiles improved, whereas levels of γ-glutamiltransferase and alanine aminotransferase significantly increased; 1 subject interrupted treatment because of hepatotoxicity. In group B, an increase in γ-glutamiltransferase levels was also observed, and 3 patients interrupted treatment because of central nervous system symptoms. Two patients in group C withdrew therapy. Quality of life significantly improved for groups A and B. In patients receiving effective PI-based therapy, the replacement of the PI with either nevirapine or efavirenz is safe and virologically effective.

Original languageEnglish
Pages (from-to)504-510
Number of pages7
JournalClinical Infectious Diseases
Volume34
Issue number4
DOIs
StatePublished - 15 Feb 2002
Externally publishedYes

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