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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Virologic outcomes of HAART with concurrent use of cytochrome P450 enzyme-inducing antiepileptics: A retrospective case control study
AIDS Research and Therapy, Volume 8, Article 18, Year 2011
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Description
Background: To evaluate the efficacy of highly-active antiretroviral therapy (HAART) in individuals taking cytochrome P450 enzyme-inducing antiepileptics (EI-EADs), we evaluated the virologic response to HAART with or without concurrent antiepileptic use.Methods: Participants in the US Military HIV Natural History Study were included if taking HAART for ≥6 months with concurrent use of EI-AEDs phenytoin, carbamazepine, or phenobarbital for ≥28 days. Virologic outcomes were compared to HAART-treated participants taking AEDs that are not CYP450 enzyme-inducing (NEI-AED group) as well as to a matched group of individuals not taking AEDs (non-AED group). For participants with multiple HAART regimens with AED overlap, the first 3 overlaps were studied.Results: EI-AED participants (n = 19) had greater virologic failure (62.5%) compared to NEI-AED participants (n = 85; 26.7%) for the first HAART/AED overlap period (OR 4.58 [1.47-14.25]; P = 0.009). Analysis of multiple overlap periods yielded consistent results (OR 4.29 [1.51-12.21]; P = 0.006). Virologic failure was also greater in the EI-AED versus NEI-AED group with multiple HAART/AED overlaps when adjusted for both year of and viral load at HAART initiation (OR 4.19 [1.54-11.44]; P = 0.005). Compared to the non-AED group (n = 190), EI-AED participants had greater virologic failure (62.5% vs. 42.5%; P = 0.134), however this result was only significant when adjusted for viral load at HAART initiation (OR 4.30 [1.02-18.07]; P = 0.046).Conclusions: Consistent with data from pharmacokinetic studies demonstrating that EI-AED use may result in subtherapeutic levels of HAART, EI-AED use is associated with greater risk of virologic failure compared to NEI-AEDs when co-administered with HAART. Concurrent use of EI-AEDs and HAART should be avoided when possible. © 2011 Okulicz et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Okulicz, Jason F.
United States, Rockville
National Cancer Institute Nci
United States, Fort Sam Houston
Brooke Army Medical Center
Grandits, Greg A.
United States, Rockville
National Cancer Institute Nci
United States, Minneapolis
University of Minnesota Twin Cities
French, Jacqueline A.
United States, New York
Nyu Langone Health
George, Jomy M.
United States, Philadelphia
Philadelphia College of Pharmacy
Simpson, David M.
United States, New York
Icahn School of Medicine at Mount Sinai
Birbeck, Gretchen Lano
United States, East Lansing
Michigan State University
Ganesan, Anuradha
United States, Rockville
National Cancer Institute Nci
United States, Bethesda
Walter Reed National Military Medical Center
Weintrob, Amy C.
United States, Rockville
National Cancer Institute Nci
United States, Bethesda
Walter Reed National Military Medical Center
Crum-Cianflone, Nancy F.
United States, Rockville
National Cancer Institute Nci
United States, San Diego
Naval Medical Center San Diego
Lalani, Tahaniyat N.
United States, Rockville
National Cancer Institute Nci
Statistics
Citations: 26
Authors: 10
Affiliations: 9
Identifiers
Doi:
10.1186/1742-6405-8-18
ISSN:
17426405
Research Areas
Infectious Diseases
Study Design
Cohort Study
Case-Control Study