Abstract
Here, we describe severe neuropsychiatric symptoms in an HIV-positive Asian man with extremely high efavirenz plasma levels while receiving standard treatment with efavirenz/tenofovir/emtricitabine fixed-dose regimen. Genetic examination revealed compound homozygosity for loss-of-function alleles of CYP2B6, including coding for a rare truncated protein. Neuropsychiatric symptoms resolved completely after efavirenz discontinuation.
MeSH terms
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Adult
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Alkynes
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Alleles
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Anti-HIV Agents / pharmacokinetics*
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Anti-HIV Agents / therapeutic use
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Aryl Hydrocarbon Hydroxylases / genetics
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Aryl Hydrocarbon Hydroxylases / metabolism*
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Benzoxazines / metabolism*
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Cyclopropanes
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Cytochrome P-450 CYP2B6
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Genotype
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HIV Infections / drug therapy
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HIV Infections / enzymology
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HIV Infections / genetics
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HIV-1
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Humans
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Male
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Pharmacogenetics
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Polymorphism, Single Nucleotide
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Reverse Transcriptase Inhibitors / pharmacokinetics*
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Reverse Transcriptase Inhibitors / therapeutic use
Substances
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Alkynes
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Anti-HIV Agents
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Benzoxazines
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Cyclopropanes
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Reverse Transcriptase Inhibitors
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Aryl Hydrocarbon Hydroxylases
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CYP2B6 protein, human
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Cytochrome P-450 CYP2B6
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efavirenz