Efavirenz (Sustiva, Stocrin)

Published January 25, 2001; Updated June 2018
Susa Coffey, MD
Selected References
21. Negredo  E, Cruz  L, Paredes  R, Ruiz  L, Fumaz  CR, Bonjoch  A, Gel  S, Tuldrà  A, Balagué  M, Johnston  S, Arnó  A, Jou  A, Tural  C, Sirera  G, Romeu  J, Clotet  B.
Virological, immunological, and clinical impact of switching from protease inhibitors to nevirapine or to efavirenz in patients with human immunodeficiency virus infection and long-lasting viral suppression. Clin Infect Dis. 2002 Feb;34(4):504-10
[PubMed ID: 11797178]
Seventy-seven subjects infected with human immunodeficiency virus were randomized to switch from protease inhibitor (PI) therapy to nevirapine therapy (group A; n=26) or to efavirenz therapy (group B; n=25) or to continue PI therapy (group C; n=26). At month 12, viral suppression had been maintained in 96% of patients in group A, 92% of patients in group B, and 92% of patients in group C. A significant increase in the CD4(+) level was observed in all 3 groups. In group A, lipid profiles improved, whereas levels of gamma-glutamiltransferase and alanine aminotransferase significantly increased; 1 subject interrupted treatment because of hepatotoxicity. In group B, an increase in gamma-glutamiltransferase levels was also observed, and 3 patients interrupted treatment because of central nervous system symptoms. Two patients in group C withdrew therapy. Quality of life significantly improved for groups A and B. In patients receiving effective PI-based therapy, the replacement of the PI with either nevirapine or efavirenz is safe and virologically effective.
22. Rachlis A, Becker S, Gill J, et al. Successful substitution of protease inhibitors with SUSTIVA (efavirenz) in patients with undetectable plasma HIV-1 RNA levels--results of a prospective, randomized, multicenter, open-label study (DMP 266-049). In: Program and abstracts of the 40th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 17-20, 2000; Toronto. Abstract 475.