Trough plasma nevirapine levels, immunologic and virologic responses in composite CYP2B66/18 HIV‐infected adult Nigerian patients

• Published in: Basic & clinical pharmacology & toxicology 2022-07, Vol.131 (1), p.45-52
• Main Authors: Abdullahi, Sa'ad T., Soyinka, Julius O., Bolarinwa, Rahman A., Olarewaju, Olusola J., Salami, Alakija K., Bakare‐Odunola, Moji T.
• Format: Article
• Language: English
• Subjects: absolute lymphocyte count; Adult; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; CD4 antigen; CD4+ T lymphocyte count; Cell number; CYP2B6 genotypes; Cytochrome P-450 CYP2B6 - genetics; Genotype & phenotype; Genotypes; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV RNA levels; HIV/AIDS; Human immunodeficiency virus; Humans; Lymphocytes; Lymphocytes T; Nevirapine; Nevirapine - therapeutic use; Nigeria; Plasma; Retrospective Studies; RNA - therapeutic use
• ISSN: 1742-7835; 1742-7843
• DOI: 10.1111/bcpt.13737

The influence of composite CYP2B6*6/*18 genotype on trough plasma nevirapine levels, HIV RNA levels (virologic response) and CD4+ T lymphocyte and absolute lymphocyte counts (immunologic response) of HIV‐infected patients were evaluated. Patients with records of trough plasma nevirapine levels, CD4+ T lymphocyte, absolute lymphocyte and viral load counts at baseline and months 6 and 12 after initiation of nevirapine‐based antiretroviral therapy combinations were retrospectively analysed. Participants were from a cohort of 150 patients previously genotyped and with measured plasma nevirapine levels. Relationship between genotype and nevirapine levels, absolute lymphocyte and CD4+ T lymphocyte counts and viral load were explored. Composite CYP2B6*6/*18 genotype was significantly associated with trough plasma nevirapine levels (geometric mean [standard deviation]: 4482 ng/ml [1349] of normal metabolizers vs. 4632 ng/ml [1793] of intermediate metabolizers vs. 6229 ng/ml [2549] of poor metabolizers; P 350 cells/mm3 at months 6 and 12 therapy duration respectively compared to 23.1% at baseline. Composite CYP2B6*6/*18 genotype correlated with plasma nevirapine levels but not immunologic and virologic responses.