Twelve-Year Experience of Nevirapine Use: Benefits and Convenience for Long-Term Management in a French Cohort of HIV-1–Infected Patients

Abstract

Objective: To describe safety and long-term efficacy of nevirapine (NVP) in a real-life setting.Results: From 1996 to 2008, among the 745 patients who received NVP, 592 were still followed in our center; of these, 231 had stopped NVP because of failure (42%), side effects (28%), other causes (30%). Twenty-seven percent of discontinuations occurred in the first 3 months; 68% were related to adverse events. In June 2008, 361/592 patients (61%) were still on NVP for a median duration of 176 weeks (range, 0.3–600), including 18% of naïve patients, 15% of patients who initiated NVP in the context of virologic failure, and 66% of patients with an undetectable viral load (switch strategy). Median CD4 cell count increased from 377/μL (range, 8–1449) to 549/μL (range, 144–1621). Viral load was below 200 copies/mL at the latest visit in 97%, 96%, and 100% of the patients in the naïve, failure, and switch groups, respectively. Over a 5-year period, the rate of antiretroviral drug persistence was 60.9% for NVP, 41.4% for efavirenz, and 23% for lopinavir/ritonavir (P < .0001).Conclusions: In a real-life setting, NVP demonstrates sustained efficacy and good safety and is very convenient to use as reflected by a high rate of persistency.

Keywords:

• nevirapine
• potency
• persistency