{"id":29366,"date":"2015-12-01T12:18:00","date_gmt":"2015-12-01T12:18:00","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=29366"},"modified":"2015-12-01T16:34:51","modified_gmt":"2015-12-01T16:34:51","slug":"the-effects-of-systemic-efavirenz-exposure-sex-and-age-on-risk-of-viral-non-suppression","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/29366","title":{"rendered":"The effects of systemic efavirenz exposure, sex and age on risk of viral non-suppression"},"content":{"rendered":"<p><strong><a href=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2015\/12\/pediatrics-workshop.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-29405\" src=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2015\/12\/pediatrics-workshop.png\" alt=\"HIV Pediatrics Workshop\" width=\"200\" height=\"200\" srcset=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2015\/12\/pediatrics-workshop.png 300w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2015\/12\/pediatrics-workshop-150x150.png 150w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p><strong>Pharmacokinetic (PK) sub study from CHAPAS-3 suggests new paediatric target minimum concentrations for efavirenz (EFV) &#8211; according to data presented at the 7th International Workshop on HIV Pediatrics.<\/strong><\/p>\n<p>CHAPAS-3 (Children with HIV 1 in Africa, Pharmacokinetics and Adherence\/Acceptability of Simple Antiretroviral Regimens) was an open-label, randomised, phase 2\/3 trial, conducted in Zambia and Uganda to evaluate new solid, dispersible, scored, antiretroviral fixed-dose combination and single drugs in African children.<\/p>\n<p>The sub study was conducted to describe the effect of systematic EFV exposure on viral suppression and determine the minimum exposure predictive of reduced risk of non-suppression.<\/p>\n<p>The investigators used Cox proportional hazards regression models to estimate the risk of viral non-suppression (&gt;100 copies\/mL) associated with EFV exposure and other factors as hazard ratio.<\/p>\n<p>They analysed 590 matched PK\/viral load samples from 118 children 1.7 to 13.5 years of age.<\/p>\n<p>They found the risk of non-suppression was best described using a non-linear model that showed risk of non viral suppression decreased by 40% for every 2-fold increase in mid dose concentrations (95% CI: 24 to 51%) p&lt;0.0001. The risk reached a plateau around values of 8mg\/L (log2 C12h).<\/p>\n<p>Multivariate analysis found male sex and older age to be other risk factors for viral non-suppression. See table 1.<\/p>\n<table border=\"0\">\n<caption>Table 1: Multivariate analysis risk factors for non-suppression<\/caption>\n<tbody>\n<tr>\n<th scope=\"col\">Group<\/th>\n<th scope=\"col\">Relative hazard<\/th>\n<th scope=\"col\">95% CI<\/th>\n<th scope=\"col\">p-value<\/th>\n<\/tr>\n<tr>\n<td>Girls &lt;8<\/td>\n<td colspan=\"3\">Reference<\/td>\n<\/tr>\n<tr>\n<td>Boys &lt;8<\/td>\n<td>5.55<\/td>\n<td>1.97 to 15.5<\/td>\n<td>0.001<\/td>\n<\/tr>\n<tr>\n<td>Girls&gt;8<\/td>\n<td>12.72<\/td>\n<td>4.89 to 33. 07<\/td>\n<td>&lt;0.001<\/td>\n<\/tr>\n<tr>\n<td>Boys&gt;8<\/td>\n<td>11.23<\/td>\n<td>2.64 to 47.76<\/td>\n<td>0.001<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The most predictive C12h cut off value for risk of viral non-suppression was 1.2mg\/L, p&lt;0.001. Based on their results the investigators suggested that mid-dose mid dose interval concentrations of 1.2 mg\/L should be used as the new EFV paediatric target minimum concentrations.<\/p>\n<p>Reference:<\/p>\n<p>Bienczak A et al. The effect of systematic exposure to efavirenz, sex and age on the risk of virological non-suppression in HIV-infected children. 7th International Workshop on HIV Pediatrics, 17-18 July, Vancouver, Canada. Oral abstract 2.<br \/>\n<a href=\"http:\/\/regist2.virology-education.com\/2015\/7hivped\/06_.pdf\">http:\/\/regist2.virology-education.com\/2015\/7hivped\/06_.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base Pharmacokinetic (PK) sub study from CHAPAS-3 suggests new paediatric target minimum concentrations for efavirenz (EFV) &#8211; according to data presented at the 7th International Workshop on HIV Pediatrics. CHAPAS-3 (Children with HIV 1 in Africa, Pharmacokinetics &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,32,34],"tags":[214],"class_list":["post-29366","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-paediatric-care","category-pk-and-drug-interactions","tag-paediatric-workshop-7-vancouver-2015"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/29366","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=29366"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/29366\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=29366"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=29366"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=29366"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}