Plasma Nevirapine Levels and 24-week Efficacy of a Fixed-Dose Combination of Stavudine, Lamivudine and Nevirapine (GPO-VIR) among Thai HIV-Infected Patients
Weerawat Manosuthi MD*, Sasisopin Kiertiburanakul MD**, Achara Chaovavanich MD*, Somnuek Sungkanuparph MD**
Affiliation : * Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi ** Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Background : A fixed-dose combination of stavudine, lamivudine, and nevirapine (GPO-VIR) is the most
affordable antiretroviral therapy (ART) regimen in Thailand. The data of nevirapine (NVP) level and efficacy
of this fixed-dose combination is limited.
Materials and Methods : Patients who were initiated GPO-VIR in 2004 were enrolled. NVP levels at 12 weeks
were determined. Patients were followed for 24 weeks.
Results : Fifty-nine patients with a mean age of 36.4 years and 54% male were enrolled. Mean body weight was
54.7 kgs. Median baseline CD4 and HIV-RNA were 29 cells/mm3 and 270,000 (5.4 log10) copies/mL, respec-
tively. Mean plasma NVP levels at 12 weeks was 6.4 mg/L. By linear regression, female gender (p = 0.042), and
higher weight (p = 0.020) were associated with lower NVP levels. At 24 weeks, 78% achieved undetectable
HIV-RNA and median CD4 was 156 cells/mm3.
Conclusion : NVP levels and 24-week efficacy of GPO-VIR are favorable. According to the affordable cost,
GPO-VIR should be an appropriate initial regimen for na(cid:31)ve HIV-infected patients in resource-limited settings.
Keywords : HIV, Nevirapine level, Nevirapine, GPO-VIR, Efficacy
