Sex Differences in Nevirapine Rash

Nevirapine is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has the most common treatment limiting side effect of rash. Severe rash has been observed in 3% of patients taking nevirapine in clinical trials, 85% of whom were men. In a multicenter, retrospective cohort study of all patie...

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Bibliographic Details
Published in:Clinical infectious diseases 2001-01, Vol.32 (1), p.124-129
Main Authors: Bersoff-Matcha, Susan J., Miller, William C., Aberg, Judith A., van der Horst, Charles, Hamrick, H. James, Powderly, William G., Mundy, Linda M.
Format: Article
Language:English
Subjects:
Adult
AIDS
Anti-HIV Agents - adverse effects
Anti-HIV Agents - therapeutic use
Antivirals
Biological and medical sciences
Clinical trials
Cohort Studies
Drug Eruptions
Drug toxicity and drugs side effects treatment
Exanthema
Exanthema - chemically induced
Female
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV/AIDS
Humans
Male
Medical sciences
Men
Multivariate Analysis
Nadir
Nevirapine - adverse effects
Nevirapine - therapeutic use
Pharmacology. Drug treatments
Retrospective Studies
Reverse Transcriptase Inhibitors - adverse effects
Reverse Transcriptase Inhibitors - therapeutic use
Sex Characteristics
Sex linked differences
Side effects
Toxicity: skin, dermoskeleton
Viruses
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Summary:Nevirapine is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has the most common treatment limiting side effect of rash. Severe rash has been observed in 3% of patients taking nevirapine in clinical trials, 85% of whom were men. In a multicenter, retrospective cohort study of all patients who received nevirapine over a 5-year period, severe rash was noted in 9 of 95 women and 3 of 263 men (risk ratio [RR], 8.31; 95% confidence interval [CI], 2.3-30.0; P = .005). Women were more likely to discontinue nevirapine therapy because of rash (RR, 4.5; 95% CI, 1.9-10.5; P = .0005). After adjusting for age and baseline CD4 cell count in multivariate analysis, women had a 7-fold increase in risk for severe rash and were 3.5 times more likely to discontinue nevirapine therapy. In women of reproductive age for whom contraception may occur, nevirapine remains the NNRTI of choice. Recognition of sex differences in this severe adverse event will be important in prescribing nevirapine.
ISSN:1058-4838
1537-6591
DOI:10.1086/317536