Long-term efficacy and safety of treatment with nevirapine plus nucleoside reverse transcriptase inhibitors for HIV-1 infection: An eight-years follow-up

Abstract Background The aim of this retrospective study is to evaluate long-term efficacy and safety of highly active antiretroviral therapy (HAART) regimens based on nevirapine (NVP) plus nucleoside reverse transcriptase inhibitors (NRTIs), with particular regard to NVP's effect on liver function and lipid profile, in both HAART-experienced patients and naϊve. Material and methods We have continuously treated with NVP for at least 8 years a total of 197 HIV-1 positive patients (126 males, 71 females) and we have followed-up them over a eight-years period: 54.7% of them were HAART-experienced patients and have switched to NVP for simplification, intolerance or dyslipidemia, while 45.3% were naive to antiretroviral drugs. Co-infection with hepatitis C viruses was detected in 20% of patients. Viral load, CD4+ cell count, liver enzymes and lipid profile were investigated on 2, 4, 6 and 8 years follow-up controls, retrospectively. Results The initial positive anti-viral answer obtained with NVP have been lasting in time in all patients. The patients which were continuously treated with NVP kept undetectable viral load from 2 to 8 years follow-up controls. None of these patients developed liver toxicity. An increased in of γ-GT levels occurred in the first two years of treatment, then they remained stable; AST and ALT levels showed no significant variations. Lipid levels remained in normal range, with a significant improvement of HDL-cholesterol in naive patients. Conclusion Long-term treatment with NVP is safe and effective, and it do not require use of statins in both experienced and naive patients.