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Abstract
A low dose of efavirenz provides adequate efavirenz plasma concentrations in Thai HIV-1 infected adults
A. Avihingsanon1, J. Van der Lugt1, M. Gorowara1, P. Boonrak1, S. Jina1, P. Phanuphak1, D. Burger2, K. Ruxrungtham3
Background: Dose finding studies in Thai HIV-infected population has resulted in a dose reduction of several antiretrovirals in Thai clinical practice.
We aimed to investigate the pharmacokinetics of a lower dose of efavirenz in Thai HIV-infected patients. Reducing the dose will lower the cost and potentially decrease the toxicity while maintaining its efficacy.
Methods: Thirty HIV-infected adult patients with undetectable viral load (< 50 copies/mL) under any boosted PI based HAART regimen, were enrolled. The initial dose of Efavirenz was 400 mg OD plus 2 NRTIs for 2 weeks and then efavirenz was increased to 600 mg OD for 2 weeks. Therapeutic drug monitoring of mid dose efavirenz (11-13 hours) for efavirenz 400 mg and 600 mg were performed. Plasma concentrations were measured by validated HPLC. A Wilcoxon signed rank test was used to compare plasma efavirenz concentrations between the 400 mg and 600 mg.
Results: Of 30 patients enrolled (19 men and 11 women), the median BMI was 22.9 kg/m2. Median (IQR, range) values for EFV plasma levels were 2.04 (1.81-2.56, 1.00-8.90) mg/L and 2.89 (1.97-3.60, 1.17-17.63) mg/L for EFV400 mg and 600 mg, respectively (p=0.001). None of the patients had subtherapeutic values at any given time (<1.0 mg/). Thirteen percent of EFV 400 mg and 20 % of EFV 600 mg patients had plasma concentrations above 4.0 mg/L (p=0.16).
Conclusions: For the EFV 400 mg, all subjects had adequate plasma concentration. Long- term efficacy of reduced dose in Thai/Asian population should be further explored.
AIDS 2008 - XVII International AIDS Conference
Abstract no.
TUPE0079
Suggested Citation
"A.Avihingsanon, et al.
A low dose of efavirenz provides adequate efavirenz plasma concentrations in Thai HIV-1 infected adults.
:
AIDS 2008 - XVII International AIDS Conference:
Abstract no.
TUPE0079"
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