Latest research on Efavirenz

Efavirenz (brand names Sustiva® and Stocrin®) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) and is used as part of highly active antiretroviral therapy (HAART) for the treatment of a human immunodeficiency virus (HIV) type 1. For HIV infection that has not previously been treated, efavirenz and lamivudine in combination with zidovudine or tenofovir is the preferred NNRTI-based regimen. Efavirenz is also used in combination with other antiretroviral agents as part of an expanded postexposure prophylaxis regimen to prevent HIV transmission for those exposed to materials associated with a high risk for HIV transmission.

Latest findings

The majority (92%) of NNRTI users initiated cART with Efavirenz, with the remaining receiving Nevirapine (5%) or rilpivirine (3%). [source, 2016]
Several studies including HIV-HCV–coinfected persons have shown an association between hepatotoxicity, fibrosis, or clinical liver outcomes and Nevirapine use, but not Efavirenz [6, 26–28], which represented 92% of NNRTI use in this cohort. [source, 2016]
The results of a sensitivity analysis including only Efavirenz users were not appreciably different from those reported here. [source, 2016]
NNRTI users are more likely to use a TDF/FTC backbone than PI users due to the availability of a fixed dose coformulation of Efavirenz with TDF/FTC [18]. [source, 2016]
Censoring when changes to the class of anchor agent or backbone occurred or including only boosted PI and Efavirenz recipients produced results comparable to those presented here. [source, 2016]
These guidelines recommended a preferred first-line treatment with a combination of Tenofovir disoproxil fumarate (TDF), Lamivudine (3TC) or Emtricitabine (FTC) and Efavirenz (EFV), with second-line treatment using two nucleoside analogues and a boosted protease inhibitor (PI) [1]. [source, 2016]
All the patients included in the study initiated ART with reverse transcriptase inhibitor (RTI) drugs, that is, two nucleoside reverse transcriptase inhibitors (NRTI), Zidovudine (AZT) or Stavudine (d4T) with Lamivudine (3TC) + one non-nucleoside reverse transcriptase inhibitor (NNRTI), either Nevirapine (NVP) or Efavirenz (EFV) as per the standard national AIDS programme guidelines.24 [source, 2016]
Clinical studies which have observed a pharmacokinetic–pharmacodynamic relationship (e.g. Efavirenz [11], Nevirapine [12], Lopinavir [13], raltegravir [14]) have defined antiretroviral minimum effective concentrations (MEC). [source, 2016]
In addition, many antiretrovirals (e.g. rilpivirine, Efavirenz, Tenofovir, elvitegravir and boosted protease inhibitors) are ingested with specific recommendations for food intake, which may be problematic on commercial flights when meal times are fixed. [source, 2016]
At 48 weeks 10/10 patients on Efavirenz regimens were virally suppressed, as were 8/9 patients of nevirapine-based regimens, and 7/9 patients on protease inhibitor-based (largely lopinavir-based) regimens [30]. [source, 2016]