Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz‐Containing Antiretroviral Therapy

The HIV type‐1 nonnucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV type‐1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse...

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Published in:Clinical pharmacology and therapeutics 2019-10, Vol.106 (4), p.726-733
Main Authors: Desta, Zeruesenay, Gammal, Roseann S., Gong, Li, Whirl‐Carrillo, Michelle, Gaur, Aditya H., Sukasem, Chonlaphat, Hockings, Jennifer, Myers, Alan, Swart, Marelize, Tyndale, Rachel F., Masimirembwa, Collen, Iwuchukwu, Otito F., Chirwa, Sanika, Lennox, Jeffrey, Gaedigk, Andrea, Klein, Teri E., Haas, David W.
Format: Article
Language:English
Subjects:
Alkynes
Anti-HIV Agents - pharmacology
Benzoxazines - pharmacology
Cyclopropanes
Cytochrome P-450 CYP2B6 - genetics
HIV Infections - drug therapy
HIV Infections - genetics
HIV-1
Humans
Pharmacogenetics
Pharmacogenomic Testing - methods
Practice Guidelines as Topic
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Summary:The HIV type‐1 nonnucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV type‐1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.
ISSN:0009-9236
1532-6535
DOI:10.1002/cpt.1477