Severe CNS side-effect and persistent high efavirenz plasma levels in a patient with HIV/HCV coinfection and liver cirrhosis

Scand J Infect Dis. 2005;37(6-7):520-2. doi: 10.1080/00365540410020901.

Abstract

We describe an HIV/HCV coinfected patient with liver cirrhosis, who experienced severe CNS side-effects during efavirenz-based HIV therapy. Plasma levels of efavirenz were 10 times the upper limit and remained elevated (at twice the upper limit) 4 weeks after cessation of therapy. Efavirenz resistance (K103N) developed and was probably due to 'functional' monotherapy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkynes
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / blood*
  • Anti-HIV Agents / therapeutic use
  • Benzoxazines
  • Cyclopropanes
  • Drug Resistance, Viral / genetics
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV-1 / genetics
  • Hepatitis C / complications
  • Humans
  • Liver Cirrhosis / metabolism*
  • Liver Cirrhosis / virology
  • Middle Aged
  • Mood Disorders / chemically induced*
  • Mutation
  • Oxazines / adverse effects*
  • Oxazines / blood*
  • Oxazines / therapeutic use

Substances

  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cyclopropanes
  • Oxazines
  • efavirenz