Efavirenz challenge in patients with nevirapine induced Stevens-Johnson Syndrome

DOI: 10.1080/23120053.2016.1156874
Author(s): Thandekile Cecilia ManziniDepartment of Infectious Diseases, South Africa, Bernadett Isabel GosnellDepartment of Infectious Diseases, South Africa, Melanie-Anne Amanda JohnEnhancing Care Foundation, South Africa, Department of Infectious Diseases, South Africa, Mahomed Yunus Suleman MoosaDepartment of Infectious Diseases, South Africa


Background: Non-nucleoside reverse transcriptase inhibitors (NNRTI) are recommended as part of first-line treatment by the World Health Organisation (WHO) for antiretroviral treatment (ART) naïve subjects. Due to reports of cross-toxicity between nevirapine (NVP) and efavirenz (EFV), there is reluctance to substitute EFV for NVP when serious toxicity occurs. In such cases lopinavir/ritonavir (LPV/r) remains the only alternative. We report on our experience of patients with Stevens-Johnson Syndrome (SJS) secondary to NVP who were challenged with EFV under careful supervision.

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