CYP2B6*6 genotype and high efavirenz plasma concentration but not nevirapine are associated with low lumefantrine plasma exposure and poor treatment response in HIV-malaria-coinfected patients.

摘要: We investigated the influence of efavirenz (EFV)- or nevirapine (NVP)-based antiretroviral therapy (ART) on lumefantrine plasma exposure in HIV-malaria-coinfected patients and implication pharmacogenetic variations. A total 269 HIV with uncomplicated falciparum malaria NVP-based ART (NVP-arm), EFV-based (EFV-arm) not receiving (control-arm) were enrolled treated artemether-lumefantrine. Day-7 lumefantrine, baseline EFV NVP concentrations, CYP2B6*6,*18, CYP3A4*1B, CYP3A5*3,*6,*7, ABCB1 c.3435C>T c.4036A>G genotypes determined. The median day-7 concentration was significantly lower EFV-arm compared that NVP- control-arm. High concentrations CYP2B6*6/*6 genotype correlated low high rate recurrent parasitemia. No significant effect observed. In conclusion, owing to long-term CYP3A induction, cotreatment reduces leading poor treatment response, which is more pronounced CYP2B6 slow metabolizers.