Author(s)

Wanghan Kang, You Li, Qing Zhang

Corresponding Author

Qing Zhang

ABSTRACT

Efavirenz-containing regimens are commonly prescribed to patients who are receiving rifampicin-containing therapy for tuberculosis. Their drug interaction maintains its effects through the CYP enzyme family, mainly CYP2B6 in metabolism of Efavirenz. Rifampicin is expected to accelerate the metabolism of the Efavirenz, thus lowering its plasma EFV concentration, the lower concentration of EFV is assumed to relate with the regimen failure, while the higher is related with serious CNS effects. But the variety of EFV concentration amongst patients receiving EFV-based antiretroviral regimen and RIF-based anti-tuberculosis regimen was observed, which may be related to sex, weight, ethnicity, and most dominantly, a single-nucleotide polymorphism (SNP) of CYP2B6. We summarize the evidence from the literature and discuss leading factors affecting the therapeutic effects of the EFV-RIF combination in different clinical trials and thus give recommendations for efavirenz prescription.

KEYWORDS

EFV-RIF, combination, CYP2B6, SNP