TY - JOUR
T1 - Sex differences in nevirapine rash
AU - Bersoff-Matcha, Susan J.
AU - Miller, William C.
AU - Aberg, Judith A.
AU - Van der Horst, Charles
AU - Hamrick, H. James
AU - Powderly, William G.
AU - Mundy, Linda M.
N1 - Funding Information:
Financial support: HRSA SPNS (grant BRU-900125-02-0); National Institutes of Health (grants AI-25903, AI-25867, and RR00046); Washington University AIDS Clinical Trials Unit, University of North Carolina Center for AIDS Research grant P30HD3726; Holderness Foundation; Independent Clinical Trials Unit at the University of California at San Francisco Positive Health Program, SFGH AIDS Program.
PY - 2001
Y1 - 2001
N2 - Nevirapine is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has the most common treatment limiting side effect of rash. Severe rash has been observed in 3% of patients taking nevirapine in clinical trials, 85% of whom were men. In a multicenter, retrospective cohort study of all patients who received nevirapine over a 5-year period, severe rash was noted in 9 of 95 women and 3 of 263 men (risk ratio [RR], 8.31; 95% confidence interval [CI], 2.3-30.0; P = .005). Women were more likely to discontinue nevirapine therapy because of rash (RR, 4.5; 95% CI, 1.9-10.5; P = .0005). After adjusting for age and baseline CD4 cell count in multivariate analysis, women had a 7-fold increase in risk for severe rash and were 3.5 times more likely to discontinue nevirapine therapy. In women of reproductive age for whom contraception may occur, nevirapine remains the NNRTI of choice. Recognition of sex differences in this severe adverse event will be important in prescribing nevirapine.
AB - Nevirapine is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has the most common treatment limiting side effect of rash. Severe rash has been observed in 3% of patients taking nevirapine in clinical trials, 85% of whom were men. In a multicenter, retrospective cohort study of all patients who received nevirapine over a 5-year period, severe rash was noted in 9 of 95 women and 3 of 263 men (risk ratio [RR], 8.31; 95% confidence interval [CI], 2.3-30.0; P = .005). Women were more likely to discontinue nevirapine therapy because of rash (RR, 4.5; 95% CI, 1.9-10.5; P = .0005). After adjusting for age and baseline CD4 cell count in multivariate analysis, women had a 7-fold increase in risk for severe rash and were 3.5 times more likely to discontinue nevirapine therapy. In women of reproductive age for whom contraception may occur, nevirapine remains the NNRTI of choice. Recognition of sex differences in this severe adverse event will be important in prescribing nevirapine.
UR - http://www.scopus.com/inward/record.url?scp=0035134608&partnerID=8YFLogxK
U2 - 10.1086/317536
DO - 10.1086/317536
M3 - Article
C2 - 11118391
AN - SCOPUS:0035134608
SN - 1058-4838
VL - 32
SP - 124
EP - 129
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -