Replacement of protease inhibitors by nevirapine or efavirenz in simplification and rescue interventions: which works better?

The outcome of 162 patients replacing protease inhibitors (PIs) by nonnucleoside reverse transcriptase inhibitors (NNRTIs) was retrospectively assessed. After 48 weeks of follow-up, nevirapine (NVP) and efavirenz (EFV) performed similarly well in simplification interventions in patients with undetectable viremia, while EFV provided significantly better results in rescue interventions after PI failure. Previous suboptimal exposure to nucleoside analogs conditioned lower chances of virologic success using either NVP or EFV. Both drugs were generally well tolerated, although specific toxicities could make one drug more suitable than the other for certain patients.