Effects of nevirapine: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Research Findings

Studies on the effects of nevirapine have revealed both beneficial and detrimental aspects of its use in individuals with HIV. Some research suggests that nevirapine can be effective in treating HIV and preventing mother-to-child transmission. 16 22 However, other studies highlight the potential for adverse effects, including liver damage, skin rashes, and neurological issues. 18 12 13 9 15 14 5 4 Additionally, research has demonstrated the influence of genetic variations, particularly in the CYP2B6 gene, on nevirapine metabolism and subsequent drug effectiveness. 20 6 17 For instance, individuals with the CYP2B6 516TT genotype have been found to have significantly higher nevirapine concentrations in their bloodstream compared to those with the GG or GT genotype. 17

Furthermore, studies have explored the impact of nevirapine on specific molecular mechanisms related to HIV infection and treatment. One research investigated the energetic effects of mutations in the HIV-1 reverse transcriptase enzyme, a key protein involved in viral replication, when exposed to nevirapine or efavirenz, another antiretroviral drug. 21 The study suggested that mutations observed in patients undergoing treatment with these drugs might be the most effective in terms of reducing drug binding to the enzyme, possibly contributing to drug resistance. 21 Another study examined the effect of nevirapine and efavirenz on the activity of creatine kinase, an enzyme involved in energy production within brain cells. 19 The researchers found that these drugs significantly inhibited creatine kinase activity in the brains of mice, suggesting a potential link to neurological side effects. 19 However, more research is needed to confirm these findings in humans. 19

Benefits and Risks

Benefits Summary

The primary benefits of nevirapine include its potential to treat HIV infection and prevent mother-to-child transmission. Nevirapine can inhibit the growth of the HIV virus and help improve the immune system of infected individuals. 16 Additionally, nevirapine is used to prevent HIV transmission from pregnant mothers to their children. 22 Nevirapine has the potential to extend the lifespan of individuals with HIV and enhance their quality of life. 16

Risks Summary

The main risks associated with nevirapine use include potential side effects such as liver damage, skin rashes, and neurological problems. 18 12 13 9 15 14 5 4 It is crucial to carefully consider the risks and benefits of using nevirapine based on individual circumstances and consult with a medical professional. 18 It is also important to be aware of potential side effects and seek medical advice if any concerns arise. 18

Comparison Between Studies

Commonalities Among Studies

Research on nevirapine generally agrees on its potential benefits in managing HIV infection and reducing mother-to-child transmission, along with the possibility of various adverse effects. Several studies have shown that nevirapine can help improve the immune system of infected individuals and suppress the levels of HIV virus. 16 22 However, various studies also highlight potential risks associated with nevirapine use, including liver damage, skin rashes, and neurological issues. 18 12 13 9 15 14 5 4

Differences Among Studies

Research on nevirapine may vary in terms of study populations, methodologies, and specific findings. For instance, differences in nevirapine dosage, co-administered medications, and patient characteristics (age, gender, HIV stage) can influence the observed effects and side effects. 1 3 13 10 15 14 4 6 17

Consistency and Contradictions in Results

While there is a significant degree of consistency in the findings regarding nevirapine's effects, some contradictions exist. For instance, the correlation between nevirapine use and liver damage has yielded varying results across studies. 18 9 This variability could be attributed to factors such as differences in the study populations, nevirapine dosage, and co-administered medications. 13 Additionally, the association between nevirapine and skin rashes has also shown inconsistencies. 18 12 9 Further research is needed to resolve these inconsistencies and obtain a more comprehensive understanding of the potential risks and benefits of nevirapine. 13

Practical Application and Considerations

Nevirapine has the potential to be a valuable tool in managing HIV infection and preventing mother-to-child transmission, but its use should be approached with caution due to the associated risks. 18 12 13 9 15 14 5 4 When considering nevirapine treatment, consulting with a medical professional is essential to ensure the most appropriate treatment plan based on individual circumstances. 18 Additionally, individuals taking nevirapine should be vigilant for any potential side effects and seek medical advice if necessary. 18

Limitations of Current Research

Despite the accumulated knowledge about nevirapine, there remain gaps in our understanding of its long-term effects and overall safety. 2 Furthermore, the complex interplay of genetic factors, co-administered medications, and other individual characteristics makes it challenging to fully control for these variables in research. 20 6 17

Future Research Directions

To gain a more complete understanding of nevirapine's effects, further research is crucial. This includes long-term studies to evaluate the drug's safety and efficacy over extended periods. 2 Research should also incorporate genetic factors and the effects of co-administered medications to provide more personalized insights. 20 6 17 In addition, investigations at the molecular level can shed light on the mechanisms by which nevirapine interacts with HIV-related proteins and cellular processes. 21 19 11 8

Conclusion

Research on the effects of nevirapine has provided valuable insights into its potential benefits and risks in managing HIV infection. While nevirapine has shown promise in treating HIV and preventing mother-to-child transmission, it is crucial to be aware of the potential side effects and to consult with a medical professional for personalized guidance. 18 12 13 9 15 14 5 4 Continuing research efforts are essential to further understand nevirapine's long-term effects and safety, as well as its complex interactions with individual genetic factors and other medications. 18

Literature analysis of 22 papers
Positive Content
15
Neutral Content
5
Negative Content
2
Article Type
7
1
1
0
22
1.

Randomized, controlled study of the effects of a short course of prednisone on the incidence of rash associated with nevirapine in patients infected with HIV-1.

Author: MontanerJulio S G, CahnPedro, ZalaCarlos, CasssettiLidia I, LossoMarcelo, HallDavid B, WruckJan, McDonoughMarita, GigliottiMaria, RobinsonPatrick A,

Improved CD4 cell count
Similar HIV-1 RNA response
Rash
Severe rash
Therapy discontinuation

Two weeks of prednisone treatment did not reduce the incidence of nevirapine-associated rash in HIV-1-infected patients receiving combination antiretroviral therapy. Furthermore, prednisone was associated with a higher prevalence of severe rashes and therapy discontinuations due to rash. Prednisone administration did not adversely affect virological responses or CD4 cell count changes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

A comparison of the effects of nevirapine and nelfinavir on metabolism and body habitus in antiretroviral-naive human immunodeficiency virus-infected patients: a randomized controlled study.

Author: FisacCesar, VirgiliNuria, FerrerElena, BarberaMaria J, FumeroEmilio, VilarasauConcepcio, PodzamczerDaniel

Improved lipid status
Increased survival
Reduced cardiovascular risk
Increased total cholesterol

Nelfinavir (NFV), a protease inhibitor, was compared to nevirapine (NVP), a nonnucleoside reverse transcriptase inhibitor, in HIV-infected patients. NVP offered benefits regarding lipid status, with enhanced HDL-c concentrations and decreased TC/HDL-c ratios. The inclusion of NVP should be considered for patients at high coronary risk.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Effects of short-course zidovudine on the selection of nevirapine-resistant HIV-1 in women taking single-dose nevirapine.

Author: MicekMark A, BlancoAna Judith, CarlssonJacquelyn, BeckIngrid A, DrossSandra, MatunhaLaurinda, SeidelKristy, MontoyaPablo, GanttSoren, MatedianaEduardo, JamisseLilia, GloydStephen, FrenkelLisa M

HIV Transmission Prevention
NVP Resistance

This study evaluated the effectiveness of a short course of zidovudine (ZDV) in reducing the risk of nevirapine (NVP)-resistance in HIV-1 infected pregnant women receiving a single-dose of NVP for prevention of mother-to-child transmission. The results showed that women who received ZDV+sdNVP had a lower risk of NVP-resistance compared to those who received only sdNVP (35.5% vs. 72.7%).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

5.

Effects of concurrent administration of nevirapine on the disposition of quinine in healthy volunteers.

Author: SoyinkaJulius O, OnyejiCyprian O, OmoruyiSharon I, OwolabiAdegbenga R, SarmaPullela V, CookJames M

Drug interaction

This study investigated the effect of nevirapine, an HIV drug, on the pharmacokinetics of quinine, a malaria drug.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Influence of ABCB-1 C3435T polymorphisms on plasma nevirapine and efavirenz levels and their effects on virologic and immunological outcomes in HIV/TB co-infected Thai adults under anti-retroviral therapy.

Author: UttayamakulSumonmal, LikanonsakulSirirat, ManosuthiWeerawat, WichukchindaNuanjun, ShiodaTatsuo, KhusmithSrisin

HIV treatment

ABCB-1 polymorphism affects plasma efavirenz and nelfinavir concentrations and rate of CD4+ T cell recovery after starting antiretroviral treatment (ART). This study examined the influence of ABCB-1 polymorphisms on plasma nevirapine and efavirenz levels when co-administered with rifampicin in 124 HIV/TB patients. The ABCB-1 C3435T polymorphism did not affect plasma nevirapine and efavirenz concentrations in HIV/TB co-infected Thai patients or their immunological outcome, but it did have an effect on virologic outcome in the nevirapine-treated group.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Effects of nevirapine, compared with lamivudine, on lipids and lipoproteins in HIV-1-uninfected newborns: the stopping infection from mother-to-child via breast-feeding in Africa lipid substudy.

Author: SankatsingRaaj R, WitFerdinand W, PakkerNadine, VyankandonderaJoseph, MmiroFrancis, OkongPius, KasteleinJohn J, LangeJoep M, StroesErik S, ReissPeter

Increased HDL-c

Nevirapine increased apolipoprotein A-I levels and attenuated the physiological decline in HDL-c in HIV-uninfected newborns.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Highly active antiretroviral therapy versus zidovudine/nevirapine effects on early breast milk HIV type-1 Rna: a phase II randomized clinical trial.

Author: ChungMichael H, KiarieJames N, RichardsonBarbra A, LehmanDara A, OverbaughJulie, KinuthiaJohn, NjiriFrancis, John-StewartGrace C

Reduced breast milk HIV

Highly active antiretroviral therapy (HAART) resulted in lower breast milk HIV-1 RNA levels compared to short-course ZDV plus single-dose NVP. However, both regimens showed similar suppression of breast milk HIV-1 RNA in the first 2 weeks after delivery.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Effects of nevirapine and efavirenz on HDL cholesterol levels and reverse cholesterol transport in mice.

Author: TohyamaJunichiro, BillheimerJeffrey T, FukiIlia V, RothblatGeorge H, RaderDaniel J, MillarJohn S

Increased HDL cholesterol
Cardiovascular risk

This study investigates the mechanism by which non-nucleoside reverse transcriptase inhibitors (NNRTIs) increase HDL cholesterol (HDL-C) in HIV+ patients and the potential benefits of this increase in terms of cardiovascular risk.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Oral adverse effects due to the use of Nevirapine.

Author: MouraMariela Dutra Gontijo, SennaMaria Inês Barreiros, MadureiraDavidson Fróis, FonsecaLinaena Merícy Silva, MesquitaRicardo Alves

HAART side effects
Oral adverse effects

A 29-year-old black man with HIV developed a whitish plaque in the lips and bilateral buccal mucosa, burning, taste disturbance, and xerostomia after starting Nevirapine (NVP). Discontinuation of HAART led to the complete resolution of signs and symptoms.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Risk of side effects associated with the use of nevirapine in treatment-naïve patients, with respect to gender and CD4 cell count.

Author: KnobelH, GuelarA, MonteroM, CarmonaA, LuqueS, BerenguerN, GonzálezA

Toxicity

This study aims to evaluate the effectiveness of nevirapine (NVP) usage recommendations based on CD4 count and gender in preventing side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

[Evaluation of the adverse effects of nevirapine in HIV-infected pregnant women in a South Brazilian University Hospital].

Author: KondoWilliam, AstoriAdriane de Assis Fischer de, GomesSuria El-Kouba, FernandesRachelle de Brito, SasakiMaria das Graças, SbalqueiroRenato Luiz

Improved viral load
Hepatotoxicity
Skin rash

Nevirapine was associated with a high incidence of cutaneous and hepatic toxicity in HIV-infected pregnant women. Hepatotoxicity was only observed in patients with pretreatment CD4 counts above 250 cells/microL.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Portuguese

15.

Nevirapine resistance and breast-milk HIV transmission: effects of single and extended-dose nevirapine prophylaxis in subtype C HIV-infected infants.

Author: MoorthyAnitha, GuptaAmita, BhosaleRamesh, TripathySrikanth, SastryJayagowri, KulkarniSmita, ThakarMadhuri, BharadwajRenu, KagalAnju, BhoreArvind V, PatilSandesh, KulkarniVandana, VenkataramaniVaradharajan, BalasubramaniamUsha, SuryavanshiNishi, ZiemniakCarrie, GupteNikhil, BollingerRobert, PersaudDeborah

HIV transmission prevention
Drug resistance

This study assessed nevirapine resistance in Indian infants enrolled in a trial for prevention of breast-milk HIV transmission. Results showed that NVP-resistance was detected in infants who acquired subtype C HIV infection despite receiving single-dose or extended-dose nevirapine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Effects of CYP2B6 polymorphisms on plasma nevirapine concentrations: a systematic review and meta-analysis.

Author: YoonHa Young, ChoYoung Ah, YeeJeong, GwakHye Sun

NVP treatment

Nevirapine is a drug that is used to treat HIV infection. The metabolism of nevirapine is affected by genetic variations in the cytochrome P450 (CYP) enzymes, particularly CYP2B6. This study investigated the effects of CYP2B6 variants on the plasma concentrations of nevirapine. The study found that patients with the CYP2B6 516TT genotype had higher plasma concentrations of nevirapine than patients with the GG or GT genotypes. This suggests that CYP2B6 genotyping may be useful for predicting the response to nevirapine and for adjusting doses to optimize treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Effects of the HIV treatment drugs nevirapine and efavirenz on brain creatine kinase activity.

Author: StreckEmilio L, ScainiGiselli, RezinGislaine T, MoreiraJeverson, FochesatoCeline M, RomãoPedro R T

CK inhibition

Nevirapine (NVP) and efavirenz (EFV), non-nucleoside reverse transcriptase inhibitors (NNRTIs) used for HIV infection, were found to significantly inhibit creatine kinase (CK) activity in the brains of mice. This suggests that NVP and EFV may inhibit brain CK activity, potentially contributing to their neurological adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Effects of CYP2B6 G516T polymorphisms on plasma efavirenz and nevirapine levels when co-administered with rifampicin in HIV/TB co-infected Thai adults.

Author: UttayamakulSumonmal, LikanonsakulSirirat, ManosuthiWeerawat, WichukchindaNuanjun, KalambahetiThareerat, NakayamaEmi E, ShiodaTatsuo, KhusmithSrisin

Altered drug metabolism

This study investigated whether CYP2B6 or CYP3A4 polymorphisms had effects on plasma efavirenz and nevirapine concentrations when co-administered with rifampicin in HIV/TB co-infected Thai adults.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Energetic effects for observed and unobserved HIV-1 reverse transcriptase mutations of residues L100, V106, and Y181 in the presence of nevirapine and efavirenz.

Author: SmithMarilyn B Kroeger, RaderLenea H, FranklinAmanda M, TaylorEmily V, SmithKatie D, SmithRichard H, Tirado-RivesJulian, JorgensenWilliam L

HIV-1 RT inhibition

This study investigated the effect of mutations on amino acid residues L100, V106, and Y181 for unbound HIV-1 reverse transcriptase (RT) and RT bound to nevirapine and efavirenz using Monte Carlo/free energy perturbation calculations. The results showed that the variant observed in patients dosed with either nevirapine or efavirenz binds the drug most weakly, suggesting it is the most effective of all possible codon change mutations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

22.

Independent effects of nevirapine prophylaxis and HIV-1 RNA suppression in breast milk on early perinatal HIV-1 transmission.

Author: ChungMichael H, KiarieJames N, RichardsonBarbra A, LehmanDara A, OverbaughJulie, NjiriFrancis, John-StewartGrace C

Reduced HIV-1 transmission

Peripartum administration of single-dose nevirapine to mother and infant decreases early perinatal HIV-1 transmission by means of breast milk HIV-1 RNA suppression and, independently, by providing the infant with exposure prophylaxis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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