Role of Efavirenz in HIV-infected Patients with Preceding Nevirapine-related Skin Rash

Weerawat Manosuthi, Somnuek Sungkanuparph

In the resource-limited countries, nevirapine (NVP)-based highly active antiretroviral therapy (HAART) has been widely used due to its availability and antiviral efficacy. Skin reaction is the most frequently observed adverse event from NVP. Both NVP and efavirenz (EFV) are in the same class of non-nucleoside reverse transcriptase inhibitor (NNRTI), and they also can cause skin rash and hypersensitivity reaction. To date, the previous clinical data may support the safety of subsequent use of efavirenz and encourage the physicians to use efavirenz in HIV-infected patients who had preceding nevirapine-associated skin rash. This review outlines the clinical safety data regarding use of EFV in HIV-infected patients who had preceding NVP-associated rash. (J Infect Dis Antimicrob Agents 2007;24:89-93.)