在出现奈韦拉平相关皮疹的HIV感染患者中，从奈韦拉平转换为依非韦伦未成功的预测因素。

Predicting factors for unsuccessful switching from nevirapine to efavirenz in HIV-infected patients who developed nevirapine-associated skin rash.

作者信息

Kiertiburanakul S, Malathum K, Watcharananan S, Sathapatayavongs B, Sungkanuparph S

机构信息

Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok 10400, Thailand.

出版信息

Int J STD AIDS. 2009 Mar;20(3):176-9. doi: 10.1258/ijsa.2008.008231.

DOI:10.1258/ijsa.2008.008231

PMID:19255265

Abstract

Skin rash associated with nevirapine (NVP) is common and efavirenz (EFV) is often used as a substitute. We aimed to determine the predicting factors for unsuccessful switching from NVP to EFV. A retrospective cohort study was conducted in HIV-infected patients who developed rash after taking NVP. There were 109 patients with a mean standard deviation (SD) age of 36.6 (7.4) years and 45% were males. Median (interquartile range) CD4 cell count and HIV RNA at the time of NVP initiation were 163 (50-273) cells/mm(3) and 4.6 (1.7-5.4) log copies/mL, respectively. Twenty (18.3%) patients subsequently developed EFV-associated rash. By logistic regression, history of drug allergy apart from NVP (odds ratio [OR] 11.42) and CD4 cell count <100 cells/mm(3) (OR 6.14) were significant predicting factors for EFV-associated rash. Two predicting factors for unsuccessful switching from NVP to EFV were found. Patients who have these factors need to have a close follow-up if EFV is substituted.

摘要

与奈韦拉平（NVP）相关的皮疹很常见，依非韦伦（EFV）常被用作替代品。我们旨在确定从NVP转换为EFV失败的预测因素。对服用NVP后出现皮疹的HIV感染患者进行了一项回顾性队列研究。共有109例患者，平均标准差（SD）年龄为36.6（7.4）岁，45%为男性。开始服用NVP时的CD4细胞计数中位数（四分位间距）和HIV RNA分别为163（50 - 273）个细胞/mm³和4.6（1.7 - 5.4）log拷贝/mL。随后有20例（18.3%）患者出现了与EFV相关的皮疹。通过逻辑回归分析，除NVP外的药物过敏史（比值比[OR] 11.42）和CD4细胞计数<100个细胞/mm³（OR 6.14）是与EFV相关皮疹的显著预测因素。发现了两个从NVP转换为EFV失败的预测因素。如果用EFV替代，有这些因素的患者需要密切随访。