https://scholars.lib.ntu.edu.tw/handle/123456789/503471
Title: | Effectiveness of half-a-tablet efavirenz plus 2 nucleos(t)ide reverse-transcriptase inhibitors as maintenance therapy with the guidance of therapeutic drug monitoring among virologically suppressed HIV-positive patients: A prospective study | Authors: | Huang S.-H. SHU-WEN LIN SUI-YUAN CHANG Lin Y.-T. HSIN-YUN SUN Liu W.-C. Su Y.-C. CHIEN-CHING HUNG SHAN-CHWEN CHANG |
Issue Date: | 2020 | Journal Volume: | 53 | Journal Issue: | 1 | Start page/Pages: | 60-68 | Source: | Journal of Microbiology, Immunology and Infection | Abstract: | Background: Optimal efavirenz (EFV) dose that minimizes adverse effects while maintaining efficacy has yet to be elucidated. With a therapeutic drug monitoring (TDM)-guided strategy, we assessed the effectiveness of half-a-tablet EFV plus 2 nucleos(t)ide reverse-transcriptase inhibitors (NRTIs) in HIV-infected Taiwanese who had achieved viral suppression with full-dose (600 mg) EFV. Methods: HIV-infected adults receiving EFV-containing regimens who had plasma mid-dose EFV concentration (C12) ?2.0 mg/L and had plasma HIV RNA load (PVL) <200 copies/mL were enrolled in this single-arm, open-label study by reducing EFV to half-a-tablet daily. The primary endpoint was PVL <50 copies/ml in an intention-to-treat (ITT) population at week 48. The secondary endpoints were the plasma EFV C12, the proportion of patients with plasma EFV C12 <1.0 mg/L, PVL <50 copies/ml at week 96 and week 144. Results: Between April 2013 and September 2016, 203 patients (93.6% male; median age, 39.0 years) were enrolled. The median EFV C12 before switch was 2.80 mg/L (interquartile range (IQR), 2.41–3.73), which decreased to 1.59 mg/L (IQR, 1.23–2.03) after switch with a reduction of 47.4% (IQR, 38.3–55.5%). In ITT analysis, 93.6%, 92.3% and 87.3% of the patients achieved PVL <50 copies/ml at weeks 48, 96 and 144, respectively. More than 70% of the patients reported alleviation of EFV-associated adverse effects following the switch. Conclusion: Under the guidance of TDM, switch to half-a-tablet EFV plus 2 NRTIs is effective in maintaining viral suppression in HIV-infected Taiwanese with EFV C12 ? 2.0 mg/L. ? 2018 |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/503471 | ISSN: | 1684-1182 | DOI: | 10.1016/j.jmii.2018.05.001 | SDG/Keyword: | abacavir; efavirenz; emtricitabine; lamivudine; RNA directed DNA polymerase inhibitor; tenofovir disoproxil; anti human immunodeficiency virus agent; benzoxazine derivative; efavirenz; RNA directed DNA polymerase inhibitor; adult; antiretroviral therapy; Article; clinical trial; drug blood level; drug efficacy; drug monitoring; female; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; intention to treat analysis; maintenance therapy; major clinical study; male; nonhuman; prospective study; tablet; Taiwanese; virus load; administration and dosage; combination drug therapy; Human immunodeficiency virus 1; middle aged; sustained virologic response; tablet; Adult; Anti-HIV Agents; Benzoxazines; Drug Monitoring; Drug Therapy, Combination; Female; HIV Infections; HIV-1; Humans; Male; Middle Aged; Prospective Studies; Reverse Transcriptase Inhibitors; Sustained Virologic Response; Tablets; Viral Load |
Appears in Collections: | 醫學檢驗暨生物技術學系 |
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