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M. D. de Jong, S. Vella, A. Carr, C. A. B. Boucher, A. Imrie, M. French, J. Hoy, S. Sorice, S. Pauluzzi, F. Chiodo, G. J. Weverling, M. E. van der Ende, Ph. J. Frissen, H. M. Weigel, R. H. Kauffmann, J. M. A. Lange, R. Yoon, M. Moroni, E. Hoenderdos, G. Leitz, D. A. Cooper, D. Hall, P. Reiss, High-Dose Nevirapine in Previously Untreated Human Immunodeficiency Virus Type 1-Infected Persons Does Not Result in Sustained Suppression of Viral Replication, The Journal of Infectious Diseases, Volume 175, Issue 4, April 1997, Pages 966–970, https://doi.org/10.1086/514002
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Abstract
High-dose nevirapine treatment has been reported to confer sustained antiretroviral effects, despite a rapid development of resistance. The use of this strategy was evaluated in 20 previously untreated human immunodeficiency virus type 1 (HIV-1) p24 antigenemic persons with CD4 cell counts between 100 and 500/mm3. Treatment consisted of 400 mg of nevirapine, after a 2-week lead-in dose of 200 mg. Rash was the most frequently reported adverse event, occurring in 25%. While sustained declines in p24 antigen levels were observed in the majority, serum HIV-1 RNA load and CD4 cell counts returned to baseline values within 12 weeks in virtually all subjects. The resistanceconferring tyrosine-to-cysteine substitution at reverse transcriptase position 181 was detected after 4 weeks in most subjects. These observations suggest that plasma drug levels attained with highdose nevirapine were not sufficient to inhibit nevirapine-resistant virus, although they were ∽2-fold higher than reported IC50 values of resistant virus.